{
  "schema_version": "chamgap-public-criteria-1.0",
  "title": "Birth and peanut balls × labor duration or cesarean prevention",
  "language": "en",
  "translation_date": "2026-10-16",
  "criteria_version": "1.0",
  "criteria_date": "2026-10-06",
  "condition_origin": "Chamgap's own application conditions",
  "method_sources": [
    {
      "id": "M03",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03",
      "section": "§3.1, §3.2.1–3.2.3, MECIR C5/C7/C13",
      "official_principle": "Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.",
      "review_level": "Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed."
    },
    {
      "id": "M04",
      "version": "Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04",
      "section": "§4.5, §4.6.1–4.6.3, MECIR C42",
      "official_principle": "Distinguish studies from reports and link them; do not omit a study solely because results are unreported.",
      "review_level": "Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed."
    },
    {
      "id": "M08",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08",
      "section": "§8.1–8.2.3, Table 8.2.a",
      "official_principle": "Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.",
      "review_level": "Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed."
    },
    {
      "id": "M15",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15",
      "section": "§15.2.4, §15.3.1–15.3.3",
      "official_principle": "Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.",
      "review_level": "Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed."
    },
    {
      "id": "M19",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19",
      "section": "§19.1.2, §19.2.1–19.2.4",
      "official_principle": "Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.",
      "review_level": "Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed."
    }
  ],
  "status_dictionary": {
    "Partly verified": "Some information is present in the stored source, with detailed original materials still unverified; this does not mean review passed or clinical efficacy certified",
    "Unverified": "Detailed materials for the selected condition could not be established within the stored scope; this does not mean zero effect, zero studies or safety",
    "Review incomplete": "Awaiting user review",
    "Met": "Use only within the relevant condition's scope after user review; no automatic display in this preparation",
    "Not reported": "Distinguish only within materials actually read; do not turn unread external materials into unreported findings",
    "Inaccessible": "Not applied during this preparation because actual access was not tested",
    "Not applicable": "Use with a reason for non-applicability based on an explicit question boundary",
    "Conflicting data": "Judge after actual material comparison; review was not performed during this preparation",
    "Insufficient evidence for the conditions": "Do not use as a clinical grade encompassing currently unread materials"
  },
  "requirements": [
    {
      "item_id": "N01",
      "question_type": "Evidence condition",
      "question": "Which labor-duration and cesarean claim is being checked?",
      "needed": "Selected subclaim and original grade/note",
      "role": "Required",
      "role_reason": "This condition connects Selected subclaim and original grade/note with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Selected subclaim and original grade/note must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Direct results by duration endpoint, original cesarean material and selected-question boundaries. Parent scores or pain efficacy do not fill absent subclaim values. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N02",
      "question_type": "Evidence condition",
      "question": "What was total labor duration in the trial of 90 participants?",
      "needed": "Direct total-labor-duration results",
      "role": "Required",
      "role_reason": "This condition connects Direct total-labor-duration results with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Direct total-labor-duration results must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Total-duration definition, arm values, between-group effects/95% CIs, denominators and analysis model. P=.177 does not certify zero duration effect or equivalence. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N03",
      "question_type": "Evidence condition",
      "question": "What was active-labor duration in the high-BMI trial?",
      "needed": "Active-labor duration and pain as joint outcomes",
      "role": "Required",
      "role_reason": "This condition connects Active-labor duration and pain as joint outcomes with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Active-labor duration and pain as joint outcomes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Active-labor start/end criteria, arm-specific analysis denominators, statistical meaning of ±, between-group effects/CIs and joint pain/duration hierarchy. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N04",
      "question_type": "Evidence condition",
      "question": "Whose first-stage results are reported in the epidural trial?",
      "needed": "Duration outcomes by parity subgroup",
      "role": "Required",
      "role_reason": "This condition connects Duration outcomes by parity subgroup with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Duration outcomes by parity subgroup must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Exact interaction and between-group test comparisons, parity-specific denominators, effects/CIs and prospective subgroup plans. Subgroups are not counted as new independent replications. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N05",
      "question_type": "Evidence condition",
      "question": "Were pushing time and the first stage distinguished?",
      "needed": "Direct pushing-time results",
      "role": "Required",
      "role_reason": "This condition connects Direct pushing-time results with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Direct pushing-time results must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Pushing-time start/end definitions, arm values, effects/CIs, exact P values and denominators. A null result does not certify a difference of 0 minutes. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N06",
      "question_type": "Evidence condition",
      "question": "Were different labor-duration intervals distinguished?",
      "needed": "Correspondence of time intervals, origins and endpoints",
      "role": "Required",
      "role_reason": "This condition connects Correspondence of time intervals, origins and endpoints with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Correspondence of time intervals, origins and endpoints must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Interval-specific clinical definitions, time origins, labor stages, time-specific denominators and direct comparison tables. No new pooled duration effect is calculated. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N07",
      "question_type": "Evidence condition",
      "question": "Are direct cesarean-prevention event data available?",
      "needed": "Cesarean events by arm and direct comparisons",
      "role": "Required",
      "role_reason": "This condition connects Cesarean events by arm and direct comparisons with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Cesarean events by arm and direct comparisons must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Arm-specific cesarean definitions, indications, randomized/analysis denominators, events, between-group effects/CIs and prospective endpoints. Unverified data do not mean 0 events or no preventive effect. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N08",
      "question_type": "Evidence condition",
      "question": "Does vaginal delivery among completers establish operative prevention?",
      "needed": "Delivery route and missingness for all randomized participants",
      "role": "Required",
      "role_reason": "This condition connects Delivery route and missingness for all randomized participants with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Delivery route and missingness for all randomized participants must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Delivery routes for all randomized participants, analysis exclusions, surgery/attrition reasons, arm-specific events and handling of missing data. Completer selection is not transferred into prevention for everyone randomized. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N09",
      "question_type": "Evidence condition",
      "question": "Are the ball itself and positioning/movement packages separated?",
      "needed": "Ball shape and combined-program components",
      "role": "Required",
      "role_reason": "This condition connects Ball shape and combined-program components with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Ball shape and combined-program components must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Report-specific ball shapes, ball-only/movement components, matched controls and accompanying management. No new bibliography, denominator or independent trial is created for unidentified earlier combined trials. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N10",
      "question_type": "Evidence condition",
      "question": "Are epidural, parity and high-BMI populations the same?",
      "needed": "Report-specific populations and baseline conditions",
      "role": "Required",
      "role_reason": "This condition connects Report-specific populations and baseline conditions with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Report-specific populations and baseline conditions must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Report-specific eligibility, parity, BMI thresholds, epidural/analgesic use, fetal/maternal status and arm-specific baselines. Details absent from the summary remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N11",
      "question_type": "Evidence condition",
      "question": "What are the original randomized, analysis and endpoint denominators?",
      "needed": "Participant flow and endpoint denominators by report",
      "role": "Required",
      "role_reason": "This condition connects Participant flow and endpoint denominators by report with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Participant flow and endpoint denominators by report must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Arm-specific randomized/analysis flow, exclusion reasons and duration/cesarean endpoint denominators. Report sample sizes are not summed and the same cohort is not counted as additional participants. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N12",
      "question_type": "Evidence condition",
      "question": "Are positive pain, null duration and the co-primary hierarchy distinguished?",
      "needed": "Prospective joint-outcome, multiplicity and subgroup plans",
      "role": "Required",
      "role_reason": "This condition connects Prospective joint-outcome, multiplicity and subgroup plans with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Prospective joint-outcome, multiplicity and subgroup plans must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Registration, protocol, SAP, joint-outcome success criteria, multiplicity, subgroup plans and change history. Original parent axes are preserved without regrading. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N13",
      "question_type": "Evidence condition",
      "question": "Do analgesic use and instrumental delivery support the same conclusion?",
      "needed": "Clinical events and directness by outcome",
      "role": "Required",
      "role_reason": "This condition connects Clinical events and directness by outcome with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Clinical events and directness by outcome must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Outcome-specific definitions, original values, arm denominators, effects/CIs and clinical decision criteria. Unverified outcomes are distinguished from the selected question. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N14",
      "question_type": "Evidence condition",
      "question": "Are the size and clinical importance of duration signals known?",
      "needed": "Between-group duration estimates and uncertainty",
      "role": "Required",
      "role_reason": "This condition connects Between-group duration estimates and uncertainty with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Between-group duration estimates and uncertainty must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Between-group estimands, models, variance definitions, prospective importance thresholds and stage-specific analysis tables. No new differences, CIs, effects or grades are calculated. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N15",
      "question_type": "Evidence condition",
      "question": "Can findings extend to other deliveries or later outcomes?",
      "needed": "Index-labor outcomes and subsequent follow-up",
      "role": "Required",
      "role_reason": "This condition connects Index-labor outcomes and subsequent follow-up with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Index-labor outcomes and subsequent follow-up must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Measurement timing, recovery follow-up, care settings, accompanying management and direct results. No labor-ball use, delivery, analgesic or treatment instructions are created. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N16",
      "question_type": "Evidence condition",
      "question": "Are the same reports or populations counted as new independent trials?",
      "needed": "Study, report and cohort linkage",
      "role": "Required",
      "role_reason": "This condition connects Study, report and cohort linkage with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Study, report and cohort linkage must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Original study/report identifiers and cohort/analysis-population linkage. Unique-trial counts, unique-participant totals and independent replication are unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N17",
      "question_type": "Evidence condition",
      "question": "Which materials were actually read?",
      "needed": "Reading scope of stored summaries and external originals",
      "role": "Required",
      "role_reason": "This condition connects Reading scope of stored summaries and external originals with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Reading scope of stored summaries and external originals must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Actual originals, appendices, registration/planning materials and reading records. No new clinical material was searched and no external access was verified in this work. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N18",
      "question_type": "Evidence condition",
      "question": "Where do the original bibliography and registration identifiers appear?",
      "needed": "Sources of bibliographic and registration identity",
      "role": "Required",
      "role_reason": "This condition connects Sources of bibliographic and registration identity with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Sources of bibliographic and registration identity must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Paper/registration identity, timing and content material. Identifier strings alone do not establish prospective registration or actual reading. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N19",
      "question_type": "Evidence condition",
      "question": "Were original bilingual and historical-verification statements kept distinct from current review?",
      "needed": "Scope of original text, translation and historical verification",
      "role": "Required",
      "role_reason": "This condition connects Scope of original text, translation and historical verification with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Scope of original text, translation and historical verification must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Original text, translations, correction material and review records. Historical verification is not labeled as passing current review. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N20",
      "question_type": "Evidence condition",
      "question": "Are subclaim originals distinct from parent scores and axes?",
      "needed": "Selected subclaim D and parent pain context",
      "role": "Required",
      "role_reason": "This condition connects Selected subclaim D and parent pain context with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Selected subclaim D and parent pain context must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Selected-question, original-value and parent-boundary review material. No new scores, axes, efficacy grades, independence certification or verdict changes are created. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N21",
      "question_type": "Evidence condition",
      "question": "What are the original evidence date and empty correction history?",
      "needed": "Evidence date, production date and change records",
      "role": "Required",
      "role_reason": "This condition connects Evidence date, production date and change records with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Evidence date, production date and change records must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Actual corrections, follow-up material, complete prior originals and change history. Existing original text/dates are preserved. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N22",
      "question_type": "Evidence condition",
      "question": "Are funding, product support and company involvement distinguished?",
      "needed": "Report-specific support, affiliations and analysis/publication roles",
      "role": "Required",
      "role_reason": "This condition connects Report-specific support, affiliations and analysis/publication roles with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Report-specific support, affiliations and analysis/publication roles must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Original funding, product/device support, author affiliations and analysis/publication roles. Parent independence axes are not treated as new certification. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N23",
      "question_type": "Evidence condition",
      "question": "Are allocation, blinding, measurement and selective-reporting conditions known?",
      "needed": "Design labels and actual bias conditions",
      "role": "Required",
      "role_reason": "This condition connects Design labels and actual bias conditions with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Design labels and actual bias conditions must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Methods, registration, protocols, SAPs, original analysis tables and change history. Design names alone do not establish official bias-tool/evidence-grade assessments or passing review. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N24",
      "question_type": "Evidence condition",
      "question": "Are adherence, accompanying interventions and actual exposure preserved?",
      "needed": "Actual programs, controls and labor management",
      "role": "Required",
      "role_reason": "This condition connects Actual programs, controls and labor management with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Actual programs, controls and labor management must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Original accompanying-intervention, adherence, exposure and intervention-deviation data. No new totals, repetitions, cumulative exposures or implementation/delivery methods are created. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N25",
      "question_type": "Evidence condition",
      "question": "Are safety statements distinct from actual harm collection?",
      "needed": "Harm definitions, collection, comparators and exposure denominators",
      "role": "Supplementary",
      "role_reason": "This condition connects Harm definitions, collection, controls and exposure denominators with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Harm definitions, collection, comparators and exposure denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Report-specific harm definitions, collection, severity, exposure/denominators, withdrawals and accompanying management. Cautions do not establish no harm, new safety certification or treatment instructions. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N26",
      "question_type": "Evidence condition",
      "question": "Are long-term/rare harms and post-intervention outcomes available?",
      "needed": "Direct follow-up of long-term and rare harms",
      "role": "Supplementary",
      "role_reason": "This condition connects Direct follow-up of long-term and rare harms with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Direct follow-up of long-term and rare harms must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Actual long-term/harm follow-up, exposure duration, endpoint denominators and report linkage. Unread/unverified material does not mean 0 events or safety. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N27",
      "question_type": "Evidence condition",
      "question": "Which new materials would prompt an update to this table?",
      "needed": "Changes in material, conditions, observations and verdicts",
      "role": "Required",
      "role_reason": "This condition connects Changes in material, conditions, observations and verdicts with labor duration and cesarean prevention, time intervals, subgroups, event denominators, ball and movement components, anesthesia, controls, co-primary outcomes, support and harms.",
      "application_exception": "Preserve selected subclaim D and its note that overall duration and operative events were not consistently established. Distinguish absent subclaim score, status and axes from parent pain C50. Positive pain, a primiparous interaction and vaginal delivery among completers do not establish shorter overall labor or cesarean prevention. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or labor-ball, delivery or treatment instructions.",
      "criterion": "Material for Changes in material, conditions, observations and verdicts must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Complete prior originals, new material, condition versions, separate application and review records. Material additions, condition revisions and verdict changes remain separate events. This records needed materials; no new research was executed."
    }
  ]
}