# Xylitol × lower-frequency or infection-triggered use Verdict 2994 · 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: Core S03 Vernacchio 2014 concerns high-risk children; numerical n, exact ages, eligibility and baseline risk are unverified. Preserve the original 250 participants and bibliographic ages 1–5 in S04 Persaud 2024, without implying group-specific completion/analysis denominators or complete analysis of everyone. The early 306 participants and event denominators from 1996 are not transferred to later reports. - Ingredient, formulation and route: The selected claim is two- or three-times-daily or infection-triggered xylitol use. S03 concerns lower-frequency syrup, but exact report-specific target/actual frequency is unverified; S04 records a twice-daily target and approximately two actual uses daily. A specific report for infection-triggered use alone is unlinked and is not arbitrarily assigned to S03/S04. - Dose: Preserve original frequency/formulation and the distinction between target and actual use only. Contents, per-use/daily doses, weight-specific ranges, individual adherence and exact frequency in 2014 are unverified. No new doses, conversions, schedules or pediatric prevention/treatment instructions are created. - Comparator: The parent placebo classification is broad context. Actual comparator products, ingredients, frequency, contact, concomitant care and equivalent infection management in S03/S04 are unverified. Formulation, frequency, timing and population differ together, so individual contributions or superiority are not established. - Measured outcome: The selected outcome is prevention of acute otitis media. Preserve null HR 0.88 (95% CI 0.61–1.30) in S03 and 6 versus 3 events, OR 2.04 (0.43–12.92), P=.50 and the original 9-event wording in S04. Event/child units, group-specific denominators, exact observation times, models and adjustment are unverified. HRs, ORs and risk differences are not mixed, and no new rates, effects, CIs or harm/equivalence verdicts are created. - Duration: Approximately 2–3 months across trials is a broad parent classification. Exact use/event-observation windows, initiation criteria relative to infection and post-intervention persistence in each later report are unverified. Findings are not extended into long-term prevention, treatment of existing otitis media, antibiotic replacement or dental-caries prevention. - Questions outside this scope: Transferring early five-times-daily exposure, 306 participants or precise event/effect values from 1996 into lower-frequency/infection-triggered effects or denominators; Inventing the unlinked infection-triggered-only report or automatically assigning it to S03/S04; Mixing the 2014 HR with the 2024 OR, events or denominators to establish new rates, effects, CIs, harm or equivalence; Copying 1996 values to other formulations in 1998 or establishing formulation/frequency/timing-only superiority; Inheriting parent C54, null precision or historical checks as absent subclaim values or completed current review; Generalizing to all ages, formulations, long-term outcomes, caries or treatment, or generating doses, conversions or pediatric prevention/treatment instructions ## Checklist items ### N01 · What are the selected use conditions and original subclaim grade? 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 wording is two- or three-times-daily or infection-triggered use, graded D, with a note that later direct trials did not confirm benefit. The subclaim has no score, status or assessment axes; parent C54 is not substituted. - 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: Separate subclaim score, status and assessment axes are absent from the source. - Required materials and conditions: Original wording, note, grade and parent context - Materials to obtain first: Separate subclaim score, status and assessment axes are absent from the source. - Further research: Material needed: Separate subclaim score, status and assessment axes are absent from the source. This records needed materials; no new research was executed. - Conditions for verification: Material for Original wording, note, grade and 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 wording, note, grade and parent context with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S01, S02, S03, S04 ### N02 · Did formulation, frequency and timing change together? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The stored account separates five-times-daily prophylaxis from two- or three-times-daily/infection-triggered use and records that formulation and frequency changed together, preventing isolation of formulation-only effects. - 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 effects of frequency, formulation and timing, and direct comparisons under identical conditions are unverified. - Required materials and conditions: Report-specific formulation, actual exposure and infection timing - Materials to obtain first: Independent effects of frequency, formulation and timing, and direct comparisons under identical conditions are unverified. - Further research: Material needed: Independent effects of frequency, formulation and timing, and direct comparisons under identical conditions are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Report-specific formulation, actual exposure and infection 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 Report-specific formulation, actual exposure and infection timing with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S01, S02, S03, S04 ### N03 · What are the population and denominators for high-risk children in 2014? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: S03 Vernacchio 2014 is described as a trial in high-risk children; numerical n and exact ages are unverified. The early 306 participants from 1996 are not used as this report's 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: The high-risk definition, exact ages, eligibility and group-specific allocated, completed and analyzed n are unverified. - Required materials and conditions: S03 eligibility, ages, risk and allocated/analyzed n - Materials to obtain first: The high-risk definition, exact ages, eligibility and group-specific allocated, completed and analyzed n are unverified. - Further research: Material needed: The high-risk definition, exact ages, eligibility and group-specific allocated, completed and analyzed n are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for S03 eligibility, ages, risk and allocated/analyzed n 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 S03 eligibility, ages, risk and allocated/analyzed n with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03 ### N04 · What are the 2024 population, ages and analysis denominators? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: S04 Persaud 2024 records the original 250 participants and bibliographic ages 1–5. These are not expanded into group-specific denominators, complete analysis of everyone or ages in early trials. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Group-specific allocated/completed/event-analysis denominators, detailed eligibility and baseline risk are unverified. - Required materials and conditions: S04 original count, ages, eligibility and denominator flow - Materials to obtain first: Group-specific allocated/completed/event-analysis denominators, detailed eligibility and baseline risk are unverified. - Further research: Material needed: Group-specific allocated/completed/event-analysis denominators, detailed eligibility and baseline risk are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for S04 original count, ages, eligibility and denominator flow 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 S04 original count, ages, eligibility and denominator flow with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S04 ### N05 · What was the actual lower-frequency syrup exposure in 2014? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: S03 was a pragmatic lower-frequency syrup randomized trial. The parent's grouped wording of two- or three-times-daily later use is not established as this report's exact target or actual frequency. - 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 contents, amounts, target/actual frequency, initiation relative to infection and duration are unverified. - Required materials and conditions: S03 formulation, target/actual frequency, timing and duration - Materials to obtain first: Exact contents, amounts, target/actual frequency, initiation relative to infection and duration are unverified. - Further research: Material needed: Exact contents, amounts, target/actual frequency, initiation relative to infection and duration are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for S03 formulation, target/actual frequency, timing and duration 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 S03 formulation, target/actual frequency, timing and duration with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03 ### N06 · Are the 2024 target and actual use distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: S04 distinguishes twice-daily-target syrup from the original record of approximately two actual uses daily. This does not establish identical exposure or complete adherence for every child. - 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 actual use, contents, duration, refusal, discontinuation and exposure-specific outcomes are unverified. - Required materials and conditions: S04 planned frequency, actual use and adherence distribution - Materials to obtain first: Individual actual use, contents, duration, refusal, discontinuation and exposure-specific outcomes are unverified. - Further research: Material needed: Individual actual use, contents, duration, refusal, discontinuation and exposure-specific outcomes are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for S04 planned frequency, actual use and adherence distribution 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 S04 planned frequency, actual use and adherence distribution with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S04 ### N07 · Is a direct report for use only after infection onset linked? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The selected wording and parent mention later infection-triggered trials, but the current bibliography does not explicitly link a specific report, denominator or quantitative result for use only after infection onset. It is not arbitrarily assigned to S03/S04. - 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: Infection type, onset assessment, delay, specific direct report, effects and denominators are unlinked. - Required materials and conditions: Infection definition, timing, specific report and denominators - Materials to obtain first: Infection type, onset assessment, delay, specific direct report, effects and denominators are unlinked. - Further research: Material needed: Infection type, onset assessment, delay, specific direct report, effects and denominators are unlinked. This records needed materials; no new research was executed. - Conditions for verification: Material for Infection definition, timing, specific report 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 Infection definition, timing, specific report and denominators with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03, S04 ### N08 · Are prevention before infection and treatment of existing otitis the same outcome? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The selected question concerns use frequency/timing, while the parent endpoint is prevention of acute otitis media. Use after infection onset is not converted into treatment of existing otitis, symptom relief or antibiotic replacement. - 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: Prospective definitions of prevention relative to infection timing and direct treatment-outcome evidence are unlinked. - Required materials and conditions: Timing, prevention, infection course and treatment endpoints - Materials to obtain first: Prospective definitions of prevention relative to infection timing and direct treatment-outcome evidence are unlinked. - Further research: Material needed: Prospective definitions of prevention relative to infection timing and direct treatment-outcome evidence are unlinked. This records needed materials; no new research was executed. - Conditions for verification: Material for Timing, prevention, infection course and treatment endpoints 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 Timing, prevention, infection course and treatment endpoints with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03, S04 ### N09 · What were the actual comparators in lower-frequency reports? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The parent placebo label is a broad classification. It does not verify comparator ingredients, frequency, equivalent management or infection care in each of S03/S04. - 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: Correspondence of comparator formulations, ingredients, exposure, infection care, contact and concomitant care is unverified. - Required materials and conditions: Report-specific comparator products, ingredients, frequency and contact - Materials to obtain first: Correspondence of comparator formulations, ingredients, exposure, infection care, contact and concomitant care is unverified. - Further research: Material needed: Correspondence of comparator formulations, ingredients, exposure, infection care, contact and concomitant care is unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Report-specific comparator products, ingredients, frequency and contact 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 comparator products, ingredients, frequency and contact with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03, S04 ### N10 · How were acute-otitis-media events defined? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The S03 endpoint is acute otitis media occurrence; S04 concerns acute otitis media events. Dental-caries verdict 748 is a different question and its effects are not transferred. - 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: Diagnostic criteria, assessors, first/repeated events, observation windows and event-specific denominators are unverified. - Required materials and conditions: Diagnosis, units, observation windows and ascertainment - Materials to obtain first: Diagnostic criteria, assessors, first/repeated events, observation windows and event-specific denominators are unverified. - Further research: Material needed: Diagnostic criteria, assessors, first/repeated events, observation windows and event-specific denominators are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Diagnosis, units, observation windows and ascertainment 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 Diagnosis, units, observation windows and ascertainment with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03, S04 ### N11 · What original values do the 2014 HR and confidence interval represent? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: S03 HR 0.88 (95% CI 0.61–1.30) and null-result wording are preserved. They are not converted into OR, absolute differences or an exact effect of 0, or combined with another report's events. - 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 events, observation time, adjusted model and analysis denominators are unverified. - Required materials and conditions: S03 time-to-event estimate, comparison and model - Materials to obtain first: Exact events, observation time, adjusted model and analysis denominators are unverified. - Further research: Material needed: Exact events, observation time, adjusted model and analysis denominators are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for S03 time-to-event estimate, comparison and model 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 S03 time-to-event estimate, comparison and model with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03 ### N12 · What are the original 2024 events, OR, interval and P value? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: S04 records 6 versus 3 events, OR 2.04 (0.43–12.92), P=.50. The original 250 participants and events are preserved without calculating group denominators, new rates or effects. - 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 group correspondence, event/person units, group-specific denominators, model and adjustment are unverified. - Required materials and conditions: S04 group correspondence, event units, denominators and analysis - Materials to obtain first: Exact group correspondence, event/person units, group-specific denominators, model and adjustment are unverified. - Further research: Material needed: Exact group correspondence, event/person units, group-specific denominators, model and adjustment are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for S04 group correspondence, event units, denominators 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 S04 group correspondence, event units, denominators and analysis with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S04 ### N13 · What do sparse events and the null result mean? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The stored account records only 9 events in 2024 and says the lower-frequency null result does not establish harm or complete equivalence. The wide OR interval is preserved without creating new harm/equivalence verdicts. - 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: Prospective equivalence/noninferiority plans, sufficient events and precise estimates are unverified. - Required materials and conditions: Precision, uncertainty, equivalence and noninferiority - Materials to obtain first: Prospective equivalence/noninferiority plans, sufficient events and precise estimates are unverified. - Further research: Material needed: Prospective equivalence/noninferiority plans, sufficient events and precise estimates are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Precision, uncertainty, equivalence and noninferiority 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 Precision, uncertainty, equivalence and noninferiority with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S04 ### N14 · How far are randomization, concealment and masking known? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: S03/S04 are described as randomized trials. This summary alone does not verify sequence generation, allocation concealment or participant, diagnostic-assessor or analyst masking. - 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 processes, concealment, product distinguishability and diagnostic-assessor/analyst masking are unverified. - Required materials and conditions: S03/S04 allocation, product distinguishability, assessment and analysis - Materials to obtain first: Allocation processes, concealment, product distinguishability and diagnostic-assessor/analyst masking are unverified. - Further research: Material needed: Allocation processes, concealment, product distinguishability and diagnostic-assessor/analyst masking are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for S03/S04 allocation, product distinguishability, assessment 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 S03/S04 allocation, product distinguishability, assessment and analysis with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03, S04 ### N15 · What were completion, missingness and analysis populations? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: S03 lacks numerical n; only the 250 participants in S04 are preserved. Planned frequency, actual use and refusal are not linked to each analysis population. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Group attrition, missing events, follow-up after discontinuation, ITT/PP and missing-data handling/reasons are unverified. - Required materials and conditions: Group completion, missing events, follow-up after discontinuation and ITT/PP - Materials to obtain first: Group attrition, missing events, follow-up after discontinuation, ITT/PP and missing-data handling/reasons are unverified. - Further research: Material needed: Group attrition, missing events, follow-up after discontinuation, ITT/PP and missing-data handling/reasons are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Group completion, missing events, follow-up after discontinuation and ITT/PP 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 Group completion, missing events, follow-up after discontinuation and ITT/PP with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03, S04 ### N16 · Were concurrent prevention, infection care and exposure equivalent? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The stored account compares trials with different use conditions and populations. Equivalent concurrent prevention, infection care and population exposure are not linked in the stored 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: Cointerventions, baseline infection risk, daycare exposure and differences in diagnostic access are unverified. - Required materials and conditions: Group-specific care, risk, daycare and diagnostic access - Materials to obtain first: Cointerventions, baseline infection risk, daycare exposure and differences in diagnostic access are unverified. - Further research: Material needed: Cointerventions, baseline infection risk, daycare exposure and differences in diagnostic access are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Group-specific care, risk, daycare and diagnostic access 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 Group-specific care, risk, daycare and diagnostic access with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03, S04 ### N17 · Are registration identifiers distinguished from actual reading? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The early combined row records registration does not exist because it predates registration; 2014 records not confirmed, and 2024 NCT03055091. These original records are preserved; an identifier alone does not indicate registration reading or fulfillment of prospective 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: Registration originals, change history, exact endpoint plans and details supporting historical absence wording are unverified. - Required materials and conditions: Historical registration wording, report-specific identities and access - Materials to obtain first: Registration originals, change history, exact endpoint plans and details supporting historical absence wording are unverified. - Further research: Material needed: Registration originals, change history, exact endpoint plans and details supporting historical absence wording are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Historical registration wording, report-specific identities and access 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 Historical registration wording, report-specific identities and access with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S01, S02, S03, S04 ### N18 · Are prospective hierarchy, SAP and multiple analyses known? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The parent's acute-otitis-media primary-endpoint classification is context. S03/S04 registration, protocols, SAPs and prospective hierarchy were unread in this work; a classification label does not verify prospective status. - 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: Prospective first endpoints, event analyses, frequency/formulation subgroups, multiplicity and change history are unverified. - Required materials and conditions: Plans, primary endpoints, models, subgroups and changes - Materials to obtain first: Prospective first endpoints, event analyses, frequency/formulation subgroups, multiplicity and change history are unverified. - Further research: Material needed: Prospective first endpoints, event analyses, frequency/formulation subgroups, multiplicity and change history are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Plans, primary endpoints, models, subgroups and 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 Plans, primary endpoints, models, subgroups and changes with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03, S04 ### N19 · Where do the favorable high-frequency values from 1996 belong? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 306 analyzed, 19/157 versus 31/149, a difference of 8.7 percentage points (95% CI 0.4–17.0), P=.04 in the 1996 five-times-daily gum trial are early high-frequency background. They do not supply effects or denominators for selected lower-frequency/infection-triggered use. - 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: A direct comparison varying only frequency in the same population/formulation is unlinked. No new differences, ratios or totals are calculated. - Required materials and conditions: S01 frequency, formulation, denominators and original-effect background - Materials to obtain first: A direct comparison varying only frequency in the same population/formulation is unlinked. No new differences, ratios or totals are calculated. - Further research: Material needed: A direct comparison varying only frequency in the same population/formulation is unlinked. No new differences, ratios or totals are calculated. This records needed materials; no new research was executed. - Conditions for verification: Material for S01 frequency, formulation, denominators and original-effect background 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 S01 frequency, formulation, denominators and original-effect background with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S01, S03, S04 ### N20 · Are 1998 formulation-specific directions distinguished from the combined evidence row? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The parent's early row combines 1996/1998; precise values concern 1996 gum. The separate 1998 citation concerns favorable five-times-daily gum/syrup directions and uncertain lozenges, without inheriting 1996 events or denominators. - 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: Formulation-specific 1998 denominators, exact effects/CIs and links to infection-triggered use are unverified. - Required materials and conditions: S02 bibliography/directions and precise 1996 values - Materials to obtain first: Formulation-specific 1998 denominators, exact effects/CIs and links to infection-triggered use are unverified. - Further research: Material needed: Formulation-specific 1998 denominators, exact effects/CIs and links to infection-triggered use are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for S02 bibliography/directions and precise 1996 values 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 S02 bibliography/directions and precise 1996 values with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S01, S02 ### N21 · Are research program, shared reports and independent replication distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 1996/1998 are the same early research program; S03/S04 concern different lower-frequency conditions. Early and later reports are not combined as independent success under identical use conditions; reports, sheets, participants and repeated events are not summed into new unique totals. - 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 cohort overlap, independence, replication under the same conditions and unique trial/participant totals are unverified. - Required materials and conditions: Reports, trial families, populations, use conditions and unique counts - Materials to obtain first: Actual cohort overlap, independence, replication under the same conditions and unique trial/participant totals are unverified. - Further research: Material needed: Actual cohort overlap, independence, replication under the same conditions and unique trial/participant totals are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Reports, trial families, populations, use conditions and unique counts 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 Reports, trial families, populations, use conditions and unique counts with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S01, S02, S03, S04 ### N22 · Can this generalize across duration, long-term persistence and populations? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The parent classification is approximately 2–3 months across trials. This does not verify exact duration, long-term persistence or effects in all ages/risk groups for each lower-frequency report. - 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 follow-up, long-term events, population heterogeneity, persistence after stopping and generalization are unverified. - Required materials and conditions: Report-specific observation, ages, risk groups and effect persistence - Materials to obtain first: Exact follow-up, long-term events, population heterogeneity, persistence after stopping and generalization are unverified. - Further research: Material needed: Exact follow-up, long-term events, population heterogeneity, persistence after stopping and generalization are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Report-specific observation, ages, risk groups and effect persistence 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 observation, ages, risk groups and effect persistence with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03, S04 ### N23 · Are funding, support and COI in later reports distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: S03 records NIH/non-US government support and S04 public research support. These statements alone do not verify product involvement, employee authors or all interests. - 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 product/free support, employee authors, COI, funding roles and design/analysis involvement are unverified. - Required materials and conditions: S03/S04 funding, products, employees, roles and interests - Materials to obtain first: Report-specific product/free support, employee authors, COI, funding roles and design/analysis involvement are unverified. - Further research: Material needed: Report-specific product/free support, employee authors, COI, funding roles and design/analysis involvement are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for S03/S04 funding, products, employees, roles and interests 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 S03/S04 funding, products, employees, roles and interests with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S03, S04 ### N24 · Are early support statements inherited by later reports? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The early combined row records indexed non-US government support with complete product involvement incompletely verified. This does not fill support or independence gaps in S03/S04. - 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: Product involvement, employee authors, COI and funding/research roles in each of 1996/1998 are unverified. - Required materials and conditions: Government/product-involvement scope of the early combined evidence - Materials to obtain first: Product involvement, employee authors, COI and funding/research roles in each of 1996/1998 are unverified. - Further research: Material needed: Product involvement, employee authors, COI and funding/research roles in each of 1996/1998 are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Government/product-involvement scope of the early combined evidence 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 Government/product-involvement scope of the early combined evidence with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S01, S02 ### N25 · How far are pediatric safety, refusal and discontinuation known? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Parent safety is Caution, recording syrup/lozenge diarrhea, abdominal discomfort/refusal and choking concern with gum in young children. This wording does not establish actual rates or verified lower-frequency harms. - 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 event definitions, collection, actual group exposure, denominators, discontinuation, vulnerable ages and long-term/rare harms are unverified. - Required materials and conditions: Report-specific harms, exposure, denominators, discontinuation and vulnerable ages - Materials to obtain first: Report-specific event definitions, collection, actual group exposure, denominators, discontinuation, vulnerable ages and long-term/rare harms are unverified. - Further research: Material needed: Report-specific event definitions, collection, actual group exposure, denominators, discontinuation, vulnerable ages and long-term/rare harms are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Report-specific harms, exposure, denominators, discontinuation and vulnerable ages 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 harms, exposure, denominators, discontinuation and vulnerable ages with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S01, S02, S03, S04 ### N26 · Are parent axes, subclaim D, original languages, dates and corrections distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Parent C54, B/H/R0/I1/E+/B2, null precision, four false flags, an empty override and separate subclaim D are preserved. Original Korean/English, 2026-09-07, an empty correction array, an empty deliberation string and historical cross-check wording do not become completed current content review or a 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 and assessment axes are absent from the source; external details of historical checks and current content review are unverified. - Required materials and conditions: Original parent C54, axes, absent subclaim values and historical verdict - Materials to obtain first: Subclaim score, status and assessment axes are absent from the source; external details of historical checks and current content review are unverified. - Further research: Material needed: Subclaim score, status and assessment axes are absent from the source; external details of historical checks and current content review are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Original parent C54, axes, absent subclaim values and historical verdict 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 parent C54, axes, absent subclaim values and historical verdict with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S01, S02, S03, S04 ### N27 · What was actually read, and what follow-up material is needed? 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 summary and bibliography were used, retaining the four original PubMed URLs. Abstracts, full texts, registration, protocols, SAPs, support and COI are unread/access unattempted; a URL alone does not upgrade reading or 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: External acquisition, actual reading, content review and needed original materials remain outstanding. Updates must preserve complete prior texts, condition versions, separate application records and change history. - Required materials and conditions: Stored summary, original URLs, unread external material and updates - Materials to obtain first: External acquisition, actual reading, content review and needed original materials remain outstanding. Updates must preserve complete prior texts, condition versions, separate application records and change history. - Further research: Material needed: External acquisition, actual reading, content review and needed original materials remain outstanding. Updates must preserve complete prior texts, condition versions, separate application records and change history. This records needed materials; no new research was executed. - Conditions for verification: Material for Stored summary, original URLs, unread external material and updates 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 Stored summary, original URLs, unread external material and updates with lower-frequency or infection-triggered use, report-specific actual exposure, populations, comparators, HR/OR, event units, denominators, early high-frequency background, support and harms. - Application exceptions: Preserve original numbers, frequencies, formulations and research exposure only. Do not copy 306 participants or precise event/effect values from the 1996 gum trial to other formulations in 1998. Distinguish five-times-daily from two- or three-times-daily/infection-triggered use, target from actual frequency, children from repeated events, risk differences from HR/OR, and original cautions from actual harm rates. No new totals, effects, CIs, NNTs, dose conversions, grades, independence certification, formulation/frequency-only superiority or pediatric prevention/treatment 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: S01, S02, S03, S04 ## Evidence and sources ### S01 Uhari M, Kontiokari T, Koskela M, Niemelä M. Xylitol chewing gum in prevention of acute otitis media: double blind randomised trial. BMJ. 1996;313:1180-1184. PMID: 8916749. PMCID: PMC2352484. DOI: 10.1136/bmj.313.7066.1180. [PubMed](https://pubmed.ncbi.nlm.nih.gov/8916749/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: Gum 19/157 versus 31/149; original absolute difference 8.7 percentage points (95% CI 0.4–17.0), P=.04 Record level: Early high-frequency background for the selected lower-frequency question. Only the 306 analyzed and precise events/effects from 1996 gum are linked; they do not supply effects or denominators for lower-frequency or infection-triggered use. Independent replication: Parent 2994 and the two subclaim sheets share the same preserved report context. S01/S02 belong to the same early research program; S03/S04 concern different lower-frequency conditions. A separate infection-triggered-only identity is unlinked. Four citations, three evidence rows, sheets, formulations, children and repeated events are not summed into new unique trials, participants, events or independent-replication totals; confirmed totals are unrecorded. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Original PubMed URL, PMID 8916749, PMCID PMC2352484 and DOI 10.1136/bmj.313.7066.1180 are preserved. The combined evidence row's pre-registration-era wording is historical, not new verification of individual registration absence, prospective status or access. No new full-text/registration URLs are inferred. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 8916749, PMCID PMC2352484 and DOI 10.1136/bmj.313.7066.1180 are preserved. The combined evidence row's pre-registration-era wording is historical, not new verification of individual registration absence, prospective status or access. No new full-text/registration URLs are inferred. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 8916749, PMCID PMC2352484 and DOI 10.1136/bmj.313.7066.1180 are preserved. The combined evidence row's pre-registration-era wording is historical, not new verification of individual registration absence, prospective status or access. No new full-text/registration URLs are inferred. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 8916749, PMCID PMC2352484 and DOI 10.1136/bmj.313.7066.1180 are preserved. The combined evidence row's pre-registration-era wording is historical, not new verification of individual registration absence, prospective status or access. No new full-text/registration URLs are inferred. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 8916749, PMCID PMC2352484 and DOI 10.1136/bmj.313.7066.1180 are preserved. The combined evidence row's pre-registration-era wording is historical, not new verification of individual registration absence, prospective status or access. No new full-text/registration URLs are inferred. | | Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 8916749, PMCID PMC2352484 and DOI 10.1136/bmj.313.7066.1180 are preserved. The combined evidence row's pre-registration-era wording is historical, not new verification of individual registration absence, prospective status or access. No new full-text/registration URLs are inferred. | ### S02 Uhari M, Kontiokari T, Niemelä M. A novel use of xylitol sugar in preventing acute otitis media. Pediatrics. 1998;102:879-884. PMID: 9755259. DOI: 10.1542/peds.102.4.879. [PubMed](https://pubmed.ncbi.nlm.nih.gov/9755259/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: 1998 five-times-daily gum/syrup favorable directions; lozenges uncertain, individual effects/denominators/CIs unverified Record level: Background from the separate 1998 citation and five-times-daily formulation-specific directions. Precise 1996 values are not inherited, and this is not used as the specific infection-triggered-only report. Independent replication: Parent 2994 and the two subclaim sheets share the same preserved report context. S01/S02 belong to the same early research program; S03/S04 concern different lower-frequency conditions. A separate infection-triggered-only identity is unlinked. Four citations, three evidence rows, sheets, formulations, children and repeated events are not summed into new unique trials, participants, events or independent-replication totals; confirmed totals are unrecorded. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Original PubMed URL, PMID 9755259, DOI 10.1542/peds.102.4.879 and unrecorded PMCID/registration identifiers are preserved. The n, precise results and support details from 1996 do not fill the separate 1998 report. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 9755259, DOI 10.1542/peds.102.4.879 and unrecorded PMCID/registration identifiers are preserved. The n, precise results and support details from 1996 do not fill the separate 1998 report. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 9755259, DOI 10.1542/peds.102.4.879 and unrecorded PMCID/registration identifiers are preserved. The n, precise results and support details from 1996 do not fill the separate 1998 report. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 9755259, DOI 10.1542/peds.102.4.879 and unrecorded PMCID/registration identifiers are preserved. The n, precise results and support details from 1996 do not fill the separate 1998 report. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 9755259, DOI 10.1542/peds.102.4.879 and unrecorded PMCID/registration identifiers are preserved. The n, precise results and support details from 1996 do not fill the separate 1998 report. | | Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 9755259, DOI 10.1542/peds.102.4.879 and unrecorded PMCID/registration identifiers are preserved. The n, precise results and support details from 1996 do not fill the separate 1998 report. | ### S03 Vernacchio L, Corwin MJ, Vezina RM, et al. Xylitol syrup for the prevention of acute otitis media. Pediatrics. 2014;133:289-295. PMID: 24394686. PMCID: PMC3904279. DOI: 10.1542/peds.2013-2373. [PubMed](https://pubmed.ncbi.nlm.nih.gov/24394686/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: HR 0.88 (95% CI 0.61–1.30), null Record level: Direct lower-frequency syrup report for the selected question. The original context is high-risk children; numerical n, exact ages, frequency, duration, comparator, model and adjustment are unverified. It is not automatically identified as the infection-triggered-only report. Independent replication: Parent 2994 and the two subclaim sheets share the same preserved report context. S01/S02 belong to the same early research program; S03/S04 concern different lower-frequency conditions. A separate infection-triggered-only identity is unlinked. Four citations, three evidence rows, sheets, formulations, children and repeated events are not summed into new unique trials, participants, events or independent-replication totals; confirmed totals are unrecorded. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Original PubMed URL, PMID 24394686, PMCID PMC3904279, DOI 10.1542/peds.2013-2373 and registration-not-confirmed wording are preserved. Identifiers/URLs alone do not certify reading, prospective status or access. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 24394686, PMCID PMC3904279, DOI 10.1542/peds.2013-2373 and registration-not-confirmed wording are preserved. Identifiers/URLs alone do not certify reading, prospective status or access. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 24394686, PMCID PMC3904279, DOI 10.1542/peds.2013-2373 and registration-not-confirmed wording are preserved. Identifiers/URLs alone do not certify reading, prospective status or access. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 24394686, PMCID PMC3904279, DOI 10.1542/peds.2013-2373 and registration-not-confirmed wording are preserved. Identifiers/URLs alone do not certify reading, prospective status or access. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 24394686, PMCID PMC3904279, DOI 10.1542/peds.2013-2373 and registration-not-confirmed wording are preserved. Identifiers/URLs alone do not certify reading, prospective status or access. | | Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 24394686, PMCID PMC3904279, DOI 10.1542/peds.2013-2373 and registration-not-confirmed wording are preserved. Identifiers/URLs alone do not certify reading, prospective status or access. | ### S04 Persaud N, Azarpazhooh A, Keown-Stoneman C, et al. Xylitol for the prevention of acute otitis media episodes in children aged 1-5 years: a randomised controlled trial. Arch Dis Child. 2024. PMID: 37890960. PMCID: PMC10850643. DOI: 10.1136/archdischild-2023-325565. [PubMed](https://pubmed.ncbi.nlm.nih.gov/37890960/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: 6 versus 3 events; OR 2.04 (0.43–12.92), P=.50 Record level: Direct lower-frequency report for the selected question. Preserve the original 250 participants, bibliographic ages 1–5, twice-daily target/approximately two actual uses daily and original 9-event wording. Group-specific n, event units, model and loss to follow-up are unverified; the null result does not establish harm or equivalence. Independent replication: Parent 2994 and the two subclaim sheets share the same preserved report context. S01/S02 belong to the same early research program; S03/S04 concern different lower-frequency conditions. A separate infection-triggered-only identity is unlinked. Four citations, three evidence rows, sheets, formulations, children and repeated events are not summed into new unique trials, participants, events or independent-replication totals; confirmed totals are unrecorded. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Original PubMed URL, PMID 37890960, PMCID PMC10850643, DOI 10.1136/archdischild-2023-325565 and NCT03055091 are preserved. Registration contents, timing relative to recruitment, prospective hierarchy and changes are unread; no new full-text/registration URLs are inferred. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 37890960, PMCID PMC10850643, DOI 10.1136/archdischild-2023-325565 and NCT03055091 are preserved. Registration contents, timing relative to recruitment, prospective hierarchy and changes are unread; no new full-text/registration URLs are inferred. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 37890960, PMCID PMC10850643, DOI 10.1136/archdischild-2023-325565 and NCT03055091 are preserved. Registration contents, timing relative to recruitment, prospective hierarchy and changes are unread; no new full-text/registration URLs are inferred. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 37890960, PMCID PMC10850643, DOI 10.1136/archdischild-2023-325565 and NCT03055091 are preserved. Registration contents, timing relative to recruitment, prospective hierarchy and changes are unread; no new full-text/registration URLs are inferred. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 37890960, PMCID PMC10850643, DOI 10.1136/archdischild-2023-325565 and NCT03055091 are preserved. Registration contents, timing relative to recruitment, prospective hierarchy and changes are unread; no new full-text/registration URLs are inferred. | | Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 37890960, PMCID PMC10850643, DOI 10.1136/archdischild-2023-325565 and NCT03055091 are preserved. Registration contents, timing relative to recruitment, prospective hierarchy and changes are unread; no new full-text/registration URLs are 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. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - 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. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - 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. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - 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. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - 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. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. ## What the statuses mean - Met: A state used when required evidence is confirmed after user review. This production does not declare that review complete. - Partly verified: Some information in the stored summary is linked into the table. External comparison/content review is not complete. - Unverified: The article leaves this unverified, or required material is absent from the current stored summary. This is distinct from zero, absence or safety. - Review incomplete: User review pending. - Not reported: Not reported within the stored material actually read; not extended to the entire primary paper. - Inaccessible: Means an actual access failure. Access not attempted here is not assigned this state. - Not applicable: Not used as a substitute for an evidence gap. - Conflicting data: Requires an observed disagreement under the same comparison criteria; not automatically judged in this production. - Insufficient evidence for the conditions: Marks a gap in additional material required by the selected conditions; not a new efficacy grade. ## Change history 2026-10-16 · Public page/materials 1.0. Public pages and materials were prepared from the existing 27 items. No new clinical search, verification-status change or scoring was performed.