{
  "schema_version": "chamgap-public-criteria-1.0",
  "title": "Combined breathing added to standard care × DBP and HRV: evidence checklist",
  "language": "en",
  "translation_date": "2026-10-18",
  "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": {
    "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."
  },
  "requirements": [
    {
      "item_id": "N01",
      "question_type": "Evidence condition",
      "question": "Which DBP/HRV claim is selected?",
      "needed": "Selected claim, grade and note versus the parent SBP verdict",
      "role": "Required",
      "role_reason": "This condition connects Selected claim, grade and note versus the parent SBP verdict with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Selected claim, grade and note versus the parent SBP verdict 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: The selected subclaim has no score, status or axes fields. Do not fill them with parent scores or axes. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N02",
      "question_type": "Evidence condition",
      "question": "What outcomes are DBP and HRV?",
      "needed": "Outcome definitions, units, timing, denominators and analyses",
      "role": "Required",
      "role_reason": "This condition connects Outcome definitions, units, timing, denominators and analyses with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Outcome definitions, units, timing, denominators and analyses 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 HRV measures, units and models and original DBP tables are unverified. Do not combine DBP and HRV into one effect. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N03",
      "question_type": "Evidence condition",
      "question": "Are the populations the same?",
      "needed": "Trial eligibility, age, baseline medication and pressure/HRV",
      "role": "Required",
      "role_reason": "This condition connects Trial eligibility, age, baseline medication and pressure/HRV with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Trial eligibility, age, baseline medication and pressure/HRV 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: Ghiya eligibility/medication status and both trials' age and baseline DBP/HRV are unverified. Do not fill in the same hypertension population. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N04",
      "question_type": "Evidence condition",
      "question": "What combined program was studied?",
      "needed": "Preceding breathing, components, actual delivery and adherence",
      "role": "Required",
      "role_reason": "This condition connects Preceding breathing, components, actual delivery and adherence with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Preceding breathing, components, actual delivery and adherence must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Actual intensity, adherence and incremental component contributions are unverified. Do not attribute effects to alternate-nostril breathing alone. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N05",
      "question_type": "Evidence condition",
      "question": "What was each control?",
      "needed": "Standard care, active control, contact and existing medication/lifestyle care",
      "role": "Required",
      "role_reason": "This condition connects Standard care, active control, contact and existing medication/lifestyle care with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Standard care, active control, contact and existing medication/lifestyle care must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Arm contact, co-management and delivery details are unverified. Do not turn Ghiya's control into a 6-week standard-care control. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N06",
      "question_type": "Evidence condition",
      "question": "Are observation periods and measurement windows the same?",
      "needed": "Outcome periods, measurement timing and follow-up",
      "role": "Required",
      "role_reason": "This condition connects Outcome periods, measurement timing and follow-up with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Outcome periods, measurement timing and follow-up must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Detailed test timing is unverified. Do not count acute HRV as independent replication of 6-week pressure or long-term autonomic improvement. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N07",
      "question_type": "Evidence condition",
      "question": "Are randomized, completed, withdrawn and analysis populations the same?",
      "needed": "Outcome-specific arm denominators, missingness and withdrawal reasons",
      "role": "Required",
      "role_reason": "This condition connects Outcome-specific arm denominators, missingness and withdrawal reasons with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Outcome-specific arm denominators, missingness and withdrawal reasons 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 denominators for DBP/each HRV measure, withdrawal reasons and outcomes for all randomized participants are unverified. Calculate no new attrition rates or denominators. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N08",
      "question_type": "Evidence condition",
      "question": "What does null DBP mean?",
      "needed": "Arm DBP, between-group effects, CIs, exact P and models",
      "role": "Required",
      "role_reason": "This condition connects Arm DBP, between-group effects, CIs, exact P and models with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Arm DBP, between-group effects, CIs, exact P and models must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Arm values, effects, CIs, exact P and models are unverified. Null does not mean exact effect 0 or equivalence. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N09",
      "question_type": "Evidence condition",
      "question": "How did Mittal HRV vary by measure?",
      "needed": "Measure list, units, directions, denominators and between-group estimates",
      "role": "Required",
      "role_reason": "This condition connects Measure list, units, directions, denominators and between-group estimates with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Measure list, units, directions, denominators and between-group estimates must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Exact measures, values, effects, CIs, P and measurement conditions are unverified. Do not extend this to normalization of all HRV. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N10",
      "question_type": "Evidence condition",
      "question": "What was Ghiya's acute HRV result?",
      "needed": "Active control, measure-specific estimates, denominators and models",
      "role": "Required",
      "role_reason": "This condition connects Active control, measure-specific estimates, denominators and models with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Active control, measure-specific estimates, denominators and models must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Measures, units, arm denominators, baseline/final values, CIs, P and models are unverified. Do not transfer this into a 6-week HRV effect. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N11",
      "question_type": "Evidence condition",
      "question": "Can parent SBP numbers be transferred?",
      "needed": "SBP versus DBP/HRV and final values versus adjusted changes",
      "role": "Required",
      "role_reason": "This condition connects SBP versus DBP/HRV and final values versus adjusted changes with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for SBP versus DBP/HRV and final values versus adjusted changes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Do not turn SBP final values or existing arithmetic into DBP/HRV effects or adjusted changes. Calculate no new differences or CIs. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N12",
      "question_type": "Evidence condition",
      "question": "How did DBP/HRV analyses handle missingness and baseline values?",
      "needed": "Outcome-specific ITT/PP, adjustment, repeated models and sensitivity",
      "role": "Required",
      "role_reason": "This condition connects Outcome-specific ITT/PP, adjustment, repeated models and sensitivity with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Outcome-specific ITT/PP, adjustment, repeated models and sensitivity 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: DBP/each HRV measure's ITT/PP, missing-data handling, baseline adjustment, repeated models and sensitivity analyses are unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N13",
      "question_type": "Evidence condition",
      "question": "Were allocation, blinding and evaluation roles verified?",
      "needed": "Allocation, concealment and participant/evaluator/analyst roles",
      "role": "Required",
      "role_reason": "This condition connects Allocation, concealment and participant/evaluator/analyst roles with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Allocation, concealment and participant/evaluator/analyst 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: Allocation, concealment, evaluation/analysis roles and expectancy control are unverified. Do not fill in Ghiya as a newly established randomized trial. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N14",
      "question_type": "Evidence condition",
      "question": "Were pressure/HRV measurement conditions and quality verified?",
      "needed": "Devices, resting conditions, repeats and signal quality",
      "role": "Required",
      "role_reason": "This condition connects Devices, resting conditions, repeats and signal quality with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Devices, resting conditions, repeats and signal quality 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: Devices, rest, measurement counts, HRV recording length, breathing conditions and quality/exclusion rules are unverified. Do not merge different measurement conditions. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N15",
      "question_type": "Evidence condition",
      "question": "Does registration wording establish prospective endpoints?",
      "needed": "Registration, protocol, SAP, DBP/HRV hierarchy and changes",
      "role": "Required",
      "role_reason": "This condition connects Registration, protocol, SAP, DBP/HRV hierarchy and changes with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Registration, protocol, SAP, DBP/HRV hierarchy 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.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Registration, protocols, SAPs, measure hierarchy, multiplicity and changes are unread. An identifier alone does not verify prospective status; unverified does not mean unregistered. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N16",
      "question_type": "Evidence condition",
      "question": "Were precision and clinical meaning across measures verified?",
      "needed": "Planned comparisons, effects, CIs, important changes and sample planning",
      "role": "Required",
      "role_reason": "This condition connects Planned comparisons, effects, CIs, important changes and sample planning with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Planned comparisons, effects, CIs, important changes and sample planning 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: HRV multiple comparisons, planned contrasts, measure-specific effects/CIs, clinical importance thresholds and sample planning are unverified. Create no new effects, CIs or example measures. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N17",
      "question_type": "Evidence condition",
      "question": "Was this independently replicated under the same conditions?",
      "needed": "Report/trial families and the same measures, periods and intervention/controls",
      "role": "Required",
      "role_reason": "This condition connects Report/trial families and the same measures, periods and intervention/controls with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Report/trial families and the same measures, periods and intervention/controls must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Independent confirmation under the same DBP/HRV conditions and unique-trial/participant totals are unconfirmed. Do not simply add the two reports. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N18",
      "question_type": "Evidence condition",
      "question": "How far can results be extended?",
      "needed": "Combined/standalone, other breathing, surrogates and long-term events",
      "role": "Required",
      "role_reason": "This condition connects Combined/standalone, other breathing, surrogates and long-term events with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Combined/standalone, other breathing, surrogates and long-term events 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 evidence for extending DBP/HRV into autonomic normalization, medication reduction/replacement or clinical-event prevention is unverified. Create no new breathing or treatment instructions. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N19",
      "question_type": "Evidence condition",
      "question": "Were existing treatment and actual delivery effects verified?",
      "needed": "Existing medication, changes, lifestyle, delivery and exposure at measurement",
      "role": "Supplementary",
      "role_reason": "This condition connects Existing medication, changes, lifestyle, delivery and exposure at measurement with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Existing medication, changes, lifestyle, delivery and exposure at measurement 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 medication/changes, lifestyle factors, actual delivery and measurement-condition effects are unverified. Do not newly establish causes of change. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N20",
      "question_type": "Evidence condition",
      "question": "Were funding, products, employee authors and COI verified?",
      "needed": "Report-specific support and evaluation, analysis and publication roles",
      "role": "Required",
      "role_reason": "This condition connects Report-specific support and evaluation, analysis and publication roles with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Report-specific support and evaluation, analysis and 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: Product/training support, employee authors, COI and role/control details are unverified. Academic wording does not verify overall independence. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N21",
      "question_type": "Evidence condition",
      "question": "Were harms and their collection verified?",
      "needed": "Harm definitions, arm events, denominators, exposure time, stopping and missingness",
      "role": "Supplementary",
      "role_reason": "This condition connects Harm definitions, arm events, denominators, exposure time, stopping and missingness with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Harm definitions, arm events, denominators, exposure time, stopping and missingness must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Arm harms, collection procedures, stopping, denominators and missing data are unverified. Create no new event rates or safety claims. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N22",
      "question_type": "Evidence condition",
      "question": "Does this answer long-term and vulnerable-group safety?",
      "needed": "Long follow-up, vulnerable groups, concurrent exposure and existing treatment",
      "role": "Supplementary",
      "role_reason": "This condition connects Long follow-up, vulnerable groups, concurrent exposure and existing treatment with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Long follow-up, vulnerable groups, concurrent exposure and existing treatment 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: Long-term, vulnerable-group and existing-medication/other-cause harm data are unverified. Do not extend safety from limited samples. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N23",
      "question_type": "Evidence condition",
      "question": "How are existing verdicts and dates preserved?",
      "needed": "Parent/subclaim original values, both languages, axes, dates and correction history",
      "role": "Required",
      "role_reason": "This condition connects Parent/subclaim original values, both languages, axes, dates and correction history with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Parent/subclaim original values, both languages, axes, dates and correction history 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: Do not inherit parent scores, axes or historical cross-checks as subclaim values or current review/certification. Production dates do not become completed-review dates. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N24",
      "question_type": "Evidence condition",
      "question": "Which materials were actually read?",
      "needed": "Report-specific stored summaries, external papers, registration, plans and support",
      "role": "Required",
      "role_reason": "This condition connects Report-specific stored summaries, external papers, registration, plans and support with selected DBP and HRV, the combined adjunct, measures, timing, analysis denominators, attrition, directness and harm boundaries.",
      "application_exception": "Preserve selected D and the note that DBP was null and HRV varied by metric and study. Distinguish absent subclaim score/status/axes from parent C with 50 points. Other measures, times, controls and existing numbers do not become new effects, independent replication or totals. Create no new grades, safety certification or breathing, medication or treatment instructions.",
      "criterion": "Material for Report-specific stored summaries, external papers, registration, plans and support must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: External papers, registration, protocols, SAPs and support materials are unread and access was not attempted. URLs and historical verification wording do not become current reading or link checks. This records needed materials; no new research was executed."
    }
  ]
}