# Isolated tongue resistance training × AHI Verdict 2992 · Evidence Check Stored-material review date: Not recorded Original evidence cut-off: 2026-09-07 Review-criteria version: 1.0 Public page/material preparation date: 2026-10-16 Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect. ## Assessment scope - Population: Distinguish original report populations of 27 OSA patients in Poncin and 20 with mild-to-moderate sleep-disordered breathing in Yoshioka. Exact ages, diagnoses, baseline AHI/ESS, weight, exclusions, arm denominators and concurrent therapy are unverified. The 31-person multicomponent Guimarães trial is not copied as a tongue-only population, denominator or baseline. - Ingredient, formulation and route: Record isolated six-week tongue elevation and eight-week device-based tongue resistance within their original scopes. Retain differences in muscles, components, supervision, tools and adherence; multicomponent oropharyngeal exercise is separate background. Exact intensity, repetitions, device specifications and actual adherence are unverified; no new training methods are provided. - Dose: Preserve original programs/durations only to identify studies. Exact tongue-only intensity, repetitions, actual exposure, resistance, instruction, missed sessions and discontinuation details are unverified. Total amounts, frequency and individual intensity are not newly converted; no training/treatment prescriptions are created. - Comparator: Distinguish sham in Poncin from no intervention in Yoshioka. Actual sham movements, contact time, allocation awareness, measurement/analysis masking, concurrent standard therapy, medicines, weight and lifestyle-care differences are unverified. Different controls are not combined as the same comparison. - Measured outcome: The selected original claim is AHI improvement from isolated tongue resistance training, with subclaim grade D and note that primary AHI was null in two small trials. Distinguish Poncin null between-group primary AHI/positive secondary ESS from Yoshioka AHI P=.44/ESS P=.62. Exact tongue-only AHI values, units, measurement, models, effects, CIs and denominators are unverified. Multicomponent within-group values, tongue strength/endurance, sleepiness and app snoring are not transferred into selected AHI effects. - Duration: Preserve original durations of six weeks in Poncin and eight weeks in Yoshioka. Exact assessment dates, actual exposure durations, discontinuation, later follow-up, long-term clinical outcomes and rare harms are unverified. Three months for the multicomponent program is not the duration for this tongue-only question; no standard-treatment replacement or method instructions are created. - Questions outside this scope: Copying or calculating within-exercise-group 22.4±4.8 to 13.7±8.5/h in the 31-person multicomponent trial as tongue-only baselines, comparative effects or CIs; Converting Poncin secondary ESS, broad endurance wording, tongue strength, sleepiness or app snoring into primary AHI success; Copying Yoshioka P=.44/P=.62, 20 participants or completer analysis into Poncin values, denominators or analyses; Assigning one abrasion participant or device provision to a specific tongue trial without support, or using 27/20 participants as harm denominators; Using historical five RCTs, reports, measures or two subclaim sheets as new unique-trial, participant or event totals, or independence certification; Regrading original D/null results as zero effect, equivalence or null effects of every exercise, or filling subclaim scores with parent C46; Creating new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, tongue/breathing training, standard-treatment replacement or procedure instructions ## Checklist items ### N01 · What is the scope of the selected tongue-only question? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The selected original claim is 'AHI improvement from isolated tongue resistance training'. Distinguish multicomponent oropharyngeal AHI/symptoms and parent context covering multiple programs/endpoints; tongue-only AHI is recorded separately. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Detailed exposure and the effect of interest for the selected protocol are unverified. - Required materials and conditions: Original Korean/English claim and boundaries from multicomponent/parent context - Materials to obtain first: Detailed exposure and the effect of interest for the selected protocol are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N02 · Are subclaim D and parent C46 distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original subclaim grade is D, with note that primary AHI was null in two small trials. Subclaim score/status are absent. Parent C46 is a historical verdict covering conflicting programs/endpoints, not a new subclaim score. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Subclaim score/status fields are absent from the original. Parent values are not copied to fill them. - Required materials and conditions: Original subclaim D/note and absent score/status - Materials to obtain first: Subclaim score/status fields are absent from the original. Parent values are not copied to fill them. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ### N03 · Are Poncin and Yoshioka populations the same? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Poncin bibliography concerns OSA patients; Yoshioka concerns mild-to-moderate sleep-disordered breathing. The parent has adult context. Exact ages, diagnoses, severity, baseline AHI, weight, exclusions and concurrent therapies for each tongue trial are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Report-specific eligibility, diagnoses, baseline AHI, risks, ages and concurrent-treatment material are needed. - Required materials and conditions: OSA, mild-to-moderate sleep-disordered breathing, eligibility and severity - Materials to obtain first: Report-specific eligibility, diagnoses, baseline AHI, risks, ages and concurrent-treatment material are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N04 · Are tongue elevation, device resistance and multicomponent exercise the same intervention? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original separates six-week sham-controlled tongue elevation, eight-week device-based tongue resistance with no-intervention control and three-month multicomponent oropharyngeal exercise. Retain the original boundary that muscles, components, supervision, tools and adherence define different interventions. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Protocol-specific intensity, repetitions, tools, supervision and actual adherence are unverified. - Required materials and conditions: Muscles, components, supervision, tools and adherence - Materials to obtain first: Protocol-specific intensity, repetitions, tools, supervision and actual adherence are unverified. - Further research: Material needed: Protocol-specific intensity, repetitions, tools, supervision and actual adherence are unverified. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02, R03 ### N05 · What comparisons do sham and no intervention represent? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Distinguish tongue-only sham and no-intervention controls. Actual sham movements, contact time, concurrent standard therapy, medicines, other interventions and care-difference details are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Sham components, no-intervention conditions, contact, concurrent therapy and equal-care material are needed. - Required materials and conditions: Sham movements, contact, time, concurrent therapies and shared care - Materials to obtain first: Sham components, no-intervention conditions, contact, concurrent therapy and equal-care material are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N06 · Which programs lasted six weeks, eight weeks and three months? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve original correspondence between Poncin six weeks, Yoshioka eight weeks, Guimarães three months and their samples. Actual assessment dates, discontinuation, later follow-up and exact adherence durations are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Exact assessment, actual exposure, discontinuation and later-follow-up material are needed. - Required materials and conditions: Report-specific duration, assessment, exposure and later follow-up - Materials to obtain first: Exact assessment, actual exposure, discontinuation and later-follow-up material are needed. - Further research: Material needed: Exact assessment, actual exposure, discontinuation and later-follow-up material are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02, R03 ### N07 · How was tongue-only primary AHI measured and analyzed? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original combined tongue summary describes primary AHI and null between-group results in two trials. Exact tongue-only AHI values, units, devices, scoring, baseline/change values, models and denominators are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Report-specific AHI definitions, measurement, original values, units, baselines, denominators and models are needed. - Required materials and conditions: AHI definition, units, measurement, original values, denominators and models - Materials to obtain first: Report-specific AHI definitions, measurement, original values, units, baselines, denominators and models are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N08 · What was the original Poncin primary AHI result? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original and its citation record null between-group primary AHI in Poncin. Exact Poncin arm AHI values, comparative estimates, P values, 95% CIs, denominators and models are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Exact Poncin effects, P values, CIs, arm denominators and models are needed. Yoshioka values are not copied. - Required materials and conditions: Null comparative AHI, hierarchy, effects, CIs and denominators - Materials to obtain first: Exact Poncin effects, P values, CIs, arm denominators and models are needed. Yoshioka values are not copied. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02 ### N09 · Are secondary ESS and tongue endurance distinguished from AHI? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original citation records Poncin primary AHI null and secondary ESS positive. Broad parent wording states that positive ESS/tongue endurance were secondary to failed primary AHI. Exact values, report-specific endurance attribution and measurement are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original ESS/endurance values, CIs, units, denominators and exact report attribution of endurance are needed. - Required materials and conditions: Poncin ESS, broad endurance wording, hierarchy and attribution - Materials to obtain first: Original ESS/endurance values, CIs, units, denominators and exact report attribution of endurance are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N10 · What is the scope of Yoshioka AHI P=.44? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve Yoshioka AHI P=.44 and null comparative wording in the original, combined summary and citation. Exact arm AHI values, effects, CIs, denominators and models are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Yoshioka arm AHI original values, effects, CIs, denominators and models are needed. - Required materials and conditions: Original null comparative AHI, P value, effects and denominators - Materials to obtain first: Yoshioka arm AHI original values, effects, CIs, denominators and models are needed. - Further research: Material needed: Yoshioka arm AHI original values, effects, CIs, denominators and models are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R03 ### N11 · What separate result does ESS P=.62 represent? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original and citation specify Yoshioka ESS P=.62. It differs from positive Poncin secondary ESS and is a separate endpoint from AHI. Original ESS values, effects, CIs, denominators, prior hierarchy and timing details are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Exact ESS values, effects, CIs, denominators, plans and times are needed. - Required materials and conditions: Yoshioka ESS, times, denominators and separation from AHI - Materials to obtain first: Exact ESS values, effects, CIs, denominators, plans and times are needed. - Further research: Material needed: Exact ESS values, effects, CIs, denominators, plans and times are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R03 ### N12 · Are within-group AHI values from the 31-person multicomponent trial the selected effect? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Distinguish Guimarães exercise-group AHI 22.4±4.8 to 13.7±8.5/h from unavailable exact between-group change and 95% CI. This is background from a 31-person three-month multicomponent program, not a direct tongue-only effect. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Exact multicomponent comparative change, CI, meaning of ±, arm denominators and models are unverified. - Required materials and conditions: Multicomponent exercise-group values and missing comparative estimates - Materials to obtain first: Exact multicomponent comparative change, CI, meaning of ±, arm denominators and models are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N13 · How are multicomponent registered primary AHI and retrospective-registration wording retained? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original multicomponent evidence row records registered primary AHI; its citation contains NCT00660777 and historical retrospective-registration checking wording. Exact registration dates, recruitment order and original plans remain unread and do not replace tongue-only plans. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original multicomponent registration content, dates, plans, changes and recruitment order are needed. - Required materials and conditions: Guimarães NCT00660777, original hierarchy and registration timing - Materials to obtain first: Original multicomponent registration content, dates, plans, changes and recruitment order are needed. - Further research: Material needed: Original multicomponent registration content, dates, plans, changes and recruitment order are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N14 · Do tongue strength/endurance, sleepiness and snoring answer AHI? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original does not convert tongue strength, sleepiness or snoring into AHI success. Broad secondary-positive wording is retained separately from AHI; direct mediation and clinical links remain unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original values, measurement, hierarchy and AHI/clinical mediation links for each measure are needed. - Required materials and conditions: Measure definitions, units, primary/secondary hierarchy and clinical links - Materials to obtain first: Original values, measurement, hierarchy and AHI/clinical mediation links for each measure are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N15 · What is the scope of app scores and snoring signals? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Retain the original boundary that 'reduced app snoring = reduced AHI' lacks direct evidence. Detailed bibliography/quantification for symptom signals in other snoring trials is unverified; hypothetical reports are not added. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: App/snoring original-report identity, measurement, values and direct AHI links are needed. - Required materials and conditions: Actual reports, measurement and direct AHI links - Materials to obtain first: App/snoring original-report identity, measurement, values and direct AHI links are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ### N16 · What are exact tongue-only effects, CIs and effects of interest? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Null comparative AHI wording for two tongue trials and Yoshioka P values are present, but exact effects of interest, adjustments, 95% CIs, minimal important differences and equivalence designs are unverified. Retain the original boundary that small null trials do not establish null effects for every exercise. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Effects, CIs, effects of interest, adjustment, importance and equivalence plans are needed. - Required materials and conditions: Comparative estimation, adjustment, CIs, models and clinical importance - Materials to obtain first: Effects, CIs, effects of interest, adjustment, importance and equivalence plans are needed. - Further research: Material needed: Effects, CIs, effects of interest, adjustment, importance and equivalence plans are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N17 · What uncertainty remains with small samples of 27 and 20? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The parent identifies small studies and missing quantification as limitations. Original samples of 27 and 20 do not confirm precise null effects or universally rule out treatment effects; CIs and sample-size plans are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: AHI intervals, sample-size justification, power, importance and observation losses are needed. - Required materials and conditions: Endpoint denominators, intervals, power and follow-up - Materials to obtain first: AHI intervals, sample-size justification, power, importance and observation losses are needed. - Further research: Material needed: AHI intervals, sample-size justification, power, importance and observation losses are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N18 · What do 27 and 20 represent in each report? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original records multicomponent 31, six-week 27 and eight-week 20 separately; the combined tongue row records 27 and 20. Arm allocation, completion, analysis and AHI/ESS/strength denominators in each tongue trial are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Arm allocation, completion, analysis, endpoint denominators and exclusions are needed. - Required materials and conditions: Original participants, arm allocation, completion and endpoint denominators - Materials to obtain first: Arm allocation, completion, analysis, endpoint denominators and exclusions are needed. - Further research: Material needed: Arm allocation, completion, analysis, endpoint denominators and exclusions are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N19 · How does Yoshioka completer analysis relate to missingness? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original Yoshioka citation marks 20 participants and completer analysis. Total allocation, arm completion/analysis, discontinuation, exclusions, AHI/ESS missing-data handling and Poncin flow details are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Allocation, completion, arm losses, exclusions and measure-specific missingness/handling are needed. - Required materials and conditions: Allocation, completion, discontinuation, exclusions and endpoint missingness - Materials to obtain first: Allocation, completion, arm losses, exclusions and measure-specific missingness/handling are needed. - Further research: Material needed: Allocation, completion, arm losses, exclusions and measure-specific missingness/handling are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N20 · How much is known about random-sequence generation and concealment? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The combined tongue summary and bibliography of both tongue reports record randomized trials. Actual generation, concealment, recruitment order, arm allocation, baseline risks and implementation are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Actual random-sequence generation, concealment, recruitment, allocation and baseline-risk procedures are needed. - Required materials and conditions: Original randomized designs and actual generation, recruitment and allocation - Materials to obtain first: Actual random-sequence generation, concealment, recruitment, allocation and baseline-risk procedures are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N21 · What level of sham, participant and assessor masking is known? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Distinguish Poncin sham from Yoshioka no intervention. Allocation awareness among participants, instructors, measurers and analysts, equal contact, sham movements, tools and measurement procedures are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Masking, allocation awareness, sham content, contact, measurement and analysis procedures are needed. - Required materials and conditions: Contact, allocation awareness, measurement and analysis procedures - Materials to obtain first: Masking, allocation awareness, sham content, contact, measurement and analysis procedures are needed. - Further research: Material needed: Masking, allocation awareness, sham content, contact, measurement and analysis procedures are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N22 · Are baseline AHI, severity, weight and analysis distinguished? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Exact tongue-only baseline AHI/ESS, severity, weight, arm balance and baseline handling/adjustment are unverified. Original within-group Guimarães 22.4 is not a tongue-only baseline. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Tongue-only baselines, covariates, balance, adjustment and models are needed. - Required materials and conditions: Tongue-trial baselines, balance, covariates and adjustment - Materials to obtain first: Tongue-only baselines, covariates, balance, adjustment and models are needed. - Further research: Material needed: Tongue-only baselines, covariates, balance, adjustment and models are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N23 · How were standard therapy, other care and training compared? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original summary records tongue-only/control programs, but details of concurrent standard therapy, other care, weight/treatment changes and model handling are unverified. Retain the original boundary that symptoms alone cannot determine treatment need. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Standard therapy, concurrent treatment, care, weight changes and analysis handling are needed. - Required materials and conditions: Concurrent therapies, comparators, weight changes, treatment changes and analysis - Materials to obtain first: Standard therapy, concurrent treatment, care, weight changes and analysis handling are needed. - Further research: Material needed: Standard therapy, concurrent treatment, care, weight changes and analysis handling are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N24 · How are actual adherence, tools and intensity linked to results? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original states that muscles, components, supervision, tools and adherence define different interventions. Actual resistance, frequency, instruction, missed sessions, discontinuation and exposure-specific effects in the tongue trials are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Actual intensity, frequency, adherence, supervision, discontinuation, exposure and analysis material are needed. - Required materials and conditions: Planned/actual exposure, resistance, supervision, discontinuation and analysis - Materials to obtain first: Actual intensity, frequency, adherence, supervision, discontinuation, exposure and analysis material are needed. - Further research: Material needed: Actual intensity, frequency, adherence, supervision, discontinuation, exposure and analysis material are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N25 · What are allocation, completer and actual-use effects and missing-data handling? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Beyond original Yoshioka completer wording, ITT/PP, actual use, missingness, imputation, sensitivity, models and covariates in each tongue trial are unverified. Original comparative null wording is retained only within original-report scope. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: ITT/PP, actual use, models, adjustment, missingness and sensitivity material are needed. - Required materials and conditions: ITT/PP, adjustment, missingness, sensitivity and repeated measures - Materials to obtain first: ITT/PP, actual use, models, adjustment, missingness and sensitivity material are needed. - Further research: Material needed: ITT/PP, actual use, models, adjustment, missingness and sensitivity material are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N26 · What do NCT/UMIN identifiers and the original primary hierarchy establish? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Original tongue bibliography includes NCT03846349 and UMIN000041489; original evidence/citations record null primary AHI. Current registration content, dates, recruitment order, changes and analysis plans remain unread. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Registration content, dates, plans, hierarchy, analysis, recruitment order and change history are needed. - Required materials and conditions: Tongue-report registration, protocols, primary AHI and secondary outcomes - Materials to obtain first: Registration content, dates, plans, hierarchy, analysis, recruitment order and change history are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N27 · How are tongue-only null results and multicomponent signals preserved together? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The parent did not combine programs into blanket benefit or null conclusions. Retain separate scopes of multicomponent within-group signals, tongue-only primary null results and symptoms/strength/endurance; small null trials do not establish null effects for every possible exercise. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Direct comparisons under the same conditions, effects, CIs, independence and quantitative links are unverified. - Required materials and conditions: Each comparator, duration, components, endpoints and quantification - Materials to obtain first: Direct comparisons under the same conditions, effects, CIs, independence and quantitative links are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02, R03 ### N28 · How do two evidence groups, three bibliographies and historical five RCTs differ? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original contains two evidence rows and three citations. The parent decision historically describes five RCTs/registry cross-checking, but the full list and additional-report details are unverified. Link the combined tongue summary within each of two separate bibliographies; no hypothetical reports are added. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Related/additional reports, cohort overlap and unique-trial/participant totals are unverified. - Required materials and conditions: Combined summaries, individual bibliography, historical study counts and cohorts - Materials to obtain first: Related/additional reports, cohort overlap and unique-trial/participant totals are unverified. - Further research: Material needed: Related/additional reports, cohort overlap and unique-trial/participant totals are unverified. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02, R03 ### N29 · Which trial and roles do public/university support and device provision concern? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original multicomponent row records limited funding verification; the combined tongue row records public/university support and device provision in one trial. Which trial received the device, and support, COI, design/analysis roles and independence details, are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Individual attribution of support/device provision, COI, roles, research families and independence material are needed. - Required materials and conditions: Report-specific support, COI, devices, design, analysis and independence - Materials to obtain first: Individual attribution of support/device provision, COI, roles, research families and independence material are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02, R03 ### N30 · Do the studies answer post-training AHI and clinical outcomes? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: There is assessment context for six/eight-week tongue programs, but post-training AHI, clinical events, other durations/intensities/subgroups and standard-treatment-replacement material are unverified. Retain the original boundary that symptoms alone cannot determine severity or treatment need. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Later follow-up, clinical outcomes, other conditions, subgroups and treatment-change material are needed. - Required materials and conditions: Later follow-up, other conditions, subgroups and treatment changes - Materials to obtain first: Later follow-up, clinical outcomes, other conditions, subgroups and treatment-change material are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N31 · What material was actually read here? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The complete stored parent 2992 summary and original bibliography were used and originals preserved. The three reports were read as summaries; external abstracts, full texts, registration, plans and support material remain unread without access attempts. The 24 material slots comprise three stored summaries and 21 unread/needed external-material slots. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: External originals remain unread. Access failure or inaccessibility was not established either. - Required materials and conditions: Complete stored summary/bibliography versus external originals - Materials to obtain first: External originals remain unread. Access failure or inaccessibility was not established either. - Further research: Material needed: External originals remain unread. Access failure or inaccessibility was not established either. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02, R03 ### N32 · Are historical cross-checking and current review distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Retain original 2026-09-07, an empty corrections array and empty deliberation string. Historical checking of five RCTs, registration and primary outcomes is a parent history record, not completed current review. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Current content-review and new clinical-verification dates are unrecorded; review of existing content remains incomplete. - Required materials and conditions: Original date, empty corrections/deliberation and historical decision - Materials to obtain first: Current content-review and new clinical-verification dates are unrecorded; review of existing content remains incomplete. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ### N33 · Are original Korean/English tongue-only, multicomponent, primary and symptom boundaries retained? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original English subclaim is 'AHI improvement from isolated tongue resistance training', with note that primary AHI was null in two small trials. Parent English also distinguishes multicomponent/tongue-only and primary outcomes/symptoms/strength. No detailed external comparison was performed. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Detailed translation/correction comparisons between external papers and original Korean/English remain unverified. - Required materials and conditions: Original subclaim/note, parent Korean/English and safety - Materials to obtain first: Detailed translation/correction comparisons between external papers and original Korean/English remain unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ### N34 · How are parent axes and failed primary/positive secondary outcomes retained? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Parent axes are B/S/R0/I1/EX/B2/CX; the primary-failed-secondary-positive flag is true. Coprimary split, large hard-endpoint RCT and no-human-study flags are false. Derived grade is C; override is an empty string. Subclaim score, status and axes are absent from the original. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Selected-subclaim score, status and axes are absent; details of each original endpoint plan are unverified. - Required materials and conditions: Parent axes, original flags and absent subclaim axes - Materials to obtain first: Selected-subclaim score, status and axes are absent; details of each original endpoint plan are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ### N35 · Which trial does the one mucosal-abrasion participant belong to? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original safety wording records one exercise-arm participant in a tongue-training trial temporarily stopping because of an oral mucosal abrasion, then resuming. Exact trial attribution, definition, collection, adjudication and denominators are unverified in the current summary. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Trial attribution, definitions, collection, adjudication, exposure and observation denominators for the abrasion are needed. - Required materials and conditions: Event attribution, definition, collection, adjudication and denominator - Materials to obtain first: Trial attribution, definitions, collection, adjudication, exposure and observation denominators for the abrasion are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N36 · What are abrasion onset, stopping/resumption and follow-up times? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original records resumption after temporary discontinuation. Exposure, onset, recovery, discontinuation duration, recurrence, later harm follow-up and exact trial attribution are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Event, recovery, discontinuation duration, recurrence and later-follow-up times are needed. - Required materials and conditions: Actual exposure, onset, recovery, stopping, recurrence and follow-up - Materials to obtain first: Event, recovery, discontinuation duration, recurrence and later-follow-up times are needed. - Further research: Material needed: Event, recovery, discontinuation duration, recurrence and later-follow-up times are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N37 · Were harms collected equally in sham/no-intervention groups? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Tongue-only sham/no-intervention comparisons exist, but equal harm collection, observation periods, control event counts/denominators, comparative risks and attribution of the one participant are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Equal harm collection/observation, control events, denominators and comparative material are needed. - Required materials and conditions: Arm collection, observation, control events and denominators - Materials to obtain first: Equal harm collection/observation, control events, denominators and comparative material are needed. - Further research: Material needed: Equal harm collection/observation, control events, denominators and comparative material are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N38 · Are exposure/observation denominators and abrasion frequency known? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original describes one abrasion participant, but exposure/observation denominators, arm/trial attribution, total harms and missingness are unverified. Original samples of 27 and 20 are not that harm denominator. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Harm attribution, exposure, follow-up, arm denominators and total harm counts are needed. No new frequencies or risks are calculated. - Required materials and conditions: Exact trial/arm, actual exposure, follow-up, harms and discontinuation - Materials to obtain first: Harm attribution, exposure, follow-up, arm denominators and total harm counts are needed. No new frequencies or risks are calculated. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N39 · Are tools, training, baseline conditions and event causes distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Original mucosal-abrasion/temporary-stopping wording exists, but tool/program attribution, actual exposure, baseline conditions, concurrent care, timing and causal-adjudication details are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Tools, exposure, baseline conditions, event attribution, timing and causal assessment are needed. - Required materials and conditions: Tools, actual exposure, baseline oral conditions/disease, concurrent care and cause - Materials to obtain first: Tools, exposure, baseline conditions, event attribution, timing and causal assessment are needed. - Further research: Material needed: Tools, exposure, baseline conditions, event attribution, timing and causal assessment are needed. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N40 · What are stopping, completer analysis and losses to harm follow-up? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Temporary stopping/resumption and Yoshioka completer analysis are separate original records. Arm-specific stopping/losses, missing or selected harm reporting and later follow-up in each report are unverified. The two statements are not linked as the same trial/participant. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Harm-related stopping, losses, missingness, selective reporting and follow-up losses are needed. - Required materials and conditions: Event stopping/resumption, losses, harm missingness and selective reporting - Materials to obtain first: Harm-related stopping, losses, missingness, selective reporting and follow-up losses are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02, R03 ### N41 · What is known about other populations, independent reports and later harms? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Stored scope covers program-specific AHI/symptoms and one abrasion participant with unverified attribution. Independent harm reports under the same protocol, other severities/disease populations and post-training observation are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Independent harm material, vulnerable/severe populations and post-training follow-up are needed. - Required materials and conditions: Same protocol, vulnerable populations, severity and long-term follow-up - Materials to obtain first: Independent harm material, vulnerable/severe populations and post-training follow-up are needed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02, R03 ### N42 · Are criteria/original preservation distinguished from content review? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserved methodology, claim-type conditions and review-scope material were referenced. Condition freezing and separate observation application are distinguished from actual original-material reading/content review. Existing content review remains incomplete; this does not establish official-method certification or new clinical verification. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Update with records of original material, condition versions, separate application, change history and actual review scope. - Required materials and conditions: Preserved methodology, condition versions, separate application and actual review scope - Materials to obtain first: Update with records of original material, condition versions, separate application, change history and actual review scope. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ## Evidence and sources ### R01 Guimarães KC et al. 2009 [PubMed](https://pubmed.ncbi.nlm.nih.gov/19234106/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread without access attempts Findings recorded in the summary: Within-exercise-group AHI 22.4±4.8 to 13.7±8.5/h; exact between-group change/CI unverified Record level: Background within-exercise-group AHI from the 31-person three-month multicomponent trial. Retain original registered primary AHI, AHI/ESS signals and retrospective-registration wording; exact comparative effects, 95% CI, the meaning of ±, denominators and plans are unverified. They are not transferred into tongue-only baselines, comparative effects, intervals or duration. Independent replication: The original parent and two subclaim sheets share the same report context. R01 Guimarães is multicomponent background; distinguish the original combined tongue summary into R02 Poncin six weeks/27 participants/sham and R03 Yoshioka eight weeks/20 participants/no intervention. Three current bibliographies, historical checks of five RCTs, repeated measures and material slots are not counted as new unique trials, participants, events or independent replications. Confirmed totals and external details are unverified. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Summary read | Summary read | The original PubMed URL and PMID 19234106, DOI 10.1164/rccm.200806-981OC, NCT00660777 and unrecorded PMCID are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Abstract | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 19234106, DOI 10.1164/rccm.200806-981OC, NCT00660777 and unrecorded PMCID are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Full text | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 19234106, DOI 10.1164/rccm.200806-981OC, NCT00660777 and unrecorded PMCID are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Registration | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 19234106, DOI 10.1164/rccm.200806-981OC, NCT00660777 and unrecorded PMCID are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 19234106, DOI 10.1164/rccm.200806-981OC, NCT00660777 and unrecorded PMCID are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Analysis plan and original tables | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 19234106, DOI 10.1164/rccm.200806-981OC, NCT00660777 and unrecorded PMCID are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Intervention and harms | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 19234106, DOI 10.1164/rccm.200806-981OC, NCT00660777 and unrecorded PMCID are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Support and interests | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 19234106, DOI 10.1164/rccm.200806-981OC, NCT00660777 and unrecorded PMCID are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | ### R02 Poncin W et al. 2022 [PubMed](https://pubmed.ncbi.nlm.nih.gov/36081312/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread without access attempts Findings recorded in the summary: Tongue-only primary AHI null and secondary ESS positive; exact effects, CIs and P values unverified Record level: The original combined summary records Poncin 27 and Yoshioka 20 together. Poncin six-week sham comparison, primary AHI null and secondary ESS signal are linked separately; arm denominators, exact effects, CIs, P values and report-specific attribution of tongue endurance are unverified. Independent replication: The original parent and two subclaim sheets share the same report context. R01 Guimarães is multicomponent background; distinguish the original combined tongue summary into R02 Poncin six weeks/27 participants/sham and R03 Yoshioka eight weeks/20 participants/no intervention. Three current bibliographies, historical checks of five RCTs, repeated measures and material slots are not counted as new unique trials, participants, events or independent replications. Confirmed totals and external details are unverified. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Summary read | Summary read | The original PubMed URL and PMID 36081312, PMCID PMC9826101, DOI 10.1111/joor.13369 and NCT03846349 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Abstract | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 36081312, PMCID PMC9826101, DOI 10.1111/joor.13369 and NCT03846349 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Full text | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 36081312, PMCID PMC9826101, DOI 10.1111/joor.13369 and NCT03846349 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Registration | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 36081312, PMCID PMC9826101, DOI 10.1111/joor.13369 and NCT03846349 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 36081312, PMCID PMC9826101, DOI 10.1111/joor.13369 and NCT03846349 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Analysis plan and original tables | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 36081312, PMCID PMC9826101, DOI 10.1111/joor.13369 and NCT03846349 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Intervention and harms | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 36081312, PMCID PMC9826101, DOI 10.1111/joor.13369 and NCT03846349 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Support and interests | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 36081312, PMCID PMC9826101, DOI 10.1111/joor.13369 and NCT03846349 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | ### R03 Yoshioka J et al. 2024 [PubMed](https://pubmed.ncbi.nlm.nih.gov/38529043/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread without access attempts Findings recorded in the summary: Tongue-only AHI P=.44 and ESS P=.62; 20 participants and completer analysis Record level: Distinguish the original combined summary from individual bibliography. Retain Yoshioka eight-week no-intervention comparison, 20 participants, completer analysis and AHI/ESS P values. Poncin secondary ESS positivity or combined funding/device support is not copied into Yoshioka-specific results/support. Independent replication: The original parent and two subclaim sheets share the same report context. R01 Guimarães is multicomponent background; distinguish the original combined tongue summary into R02 Poncin six weeks/27 participants/sham and R03 Yoshioka eight weeks/20 participants/no intervention. Three current bibliographies, historical checks of five RCTs, repeated measures and material slots are not counted as new unique trials, participants, events or independent replications. Confirmed totals and external details are unverified. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Summary read | Summary read | The original PubMed URL and PMID 38529043, PMCID PMC10961225, DOI 10.2490/prm.20240010 and UMIN000041489 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Abstract | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 38529043, PMCID PMC10961225, DOI 10.2490/prm.20240010 and UMIN000041489 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Full text | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 38529043, PMCID PMC10961225, DOI 10.2490/prm.20240010 and UMIN000041489 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Registration | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 38529043, PMCID PMC10961225, DOI 10.2490/prm.20240010 and UMIN000041489 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 38529043, PMCID PMC10961225, DOI 10.2490/prm.20240010 and UMIN000041489 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Analysis plan and original tables | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 38529043, PMCID PMC10961225, DOI 10.2490/prm.20240010 and UMIN000041489 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Intervention and harms | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 38529043, PMCID PMC10961225, DOI 10.2490/prm.20240010 and UMIN000041489 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | | Support and interests | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | The original PubMed URL and PMID 38529043, PMCID PMC10961225, DOI 10.2490/prm.20240010 and UMIN000041489 are preserved. Identifiers alone do not certify original-material acquisition, reading, prior plans or condition fulfillment; full-text/registration URLs are not newly inferred. | ## Review criteria and methods These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score. - M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work. - M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work. - M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work. - M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work. - M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work. ## What the statuses mean - 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. ## Change history 2026-10-16 · Public page/materials 1.0. Public pages and materials were created from the existing 42 items. No new clinical search, verification-status change, or scoring was performed.