# Combined breathing added to standard care × DBP and HRV: evidence checklist Verdict 3001 · Evidence Check Stored-material review date: Not recorded Original evidence cut-off: 2026-09-07 Review-criteria version: 1.0 Public page/material preparation date: 2026-10-18 Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect. ## Assessment scope - Population: Mittal randomized 91 adults with hypertension continuing medication and lifestyle care; 68 completed. Preserve original 23 withdrawals and 25.3% attrition. Arm analysis denominators for DBP and each HRV measure are unverified. Ghiya has a separate 100-participant acute report; eligibility and medication status are not filled in as the same population. - Ingredient, formulation and route: The study added a combined alternate-nostril breathing program preceded by abdominal breathing to standard care. This is not converted into standalone alternate-nostril, other pranayama or combined-yoga effects. Component contributions, actual delivery, instruction and adherence are unverified. - Dose: Original study identifiers are 2 minutes of abdominal breathing followed by 10 minutes of alternate-nostril breathing, 12 minutes daily for 6 weeks. Actual exposure, adherence and discontinuation are unverified. This plan is not turned into personal breathing procedures, medication reduction/replacement or treatment instructions. - Comparator: Combined breathing added to standard management versus standard management alone. Actual medication types, doses, changes, lifestyle care and contact/attention controls are unverified. Ghiya's other-pranayama comparator is a separate acute HRV context. - Measured outcome: The selection is improved DBP or HRV. Preserve original Mittal 6-week DBP P>.05/null and the record that HRV varied by metric and study. Ghiya has an acute between-group HRV null result. Exact measures, units, between-group effects, 95% CIs and denominators are unverified. Null does not become effect 0 or equivalence, and mixed results do not become autonomic normalization. - Duration: Distinguish Mittal 6-week DBP/HRV from Ghiya acute HRV. Exact measurement timing, post-training persistence, harm follow-up, medication changes and long-term clinical events are unverified. Acute results do not become 6-week replication or long-term effects. - Questions outside this scope: Extending null DBP into exact effect 0, equivalence or absence of harm; Extending HRV results varying by metric and study into autonomic normalization; Transferring SBP final values, crude differences, P or ± into DBP/HRV effects, 95% CIs or ITT; Turning a combined adjunct, acute active comparison or shared reports into standalone effects, independent replication or participant totals; Turning an original CTRI identifier or empty registration annotation into verified prospective status or a no-registration determination; Using parent C with 50 points, academic support or caution as a subclaim score or certification of independence, precision or safety; Creating new numbers, grades, breathing procedures, medication reduction/replacement or treatment instructions ## Checklist items ### N01 · Which DBP/HRV claim is selected? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The selection is improved DBP or HRV. Preserve original grade D and the note that DBP was null and HRV varied by metric and study. Parent C with 50 points concerns 6-week SBP. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: The selected subclaim has no score, status or axes fields. Do not fill them with parent scores or axes. - Required materials and conditions: Selected claim, grade and note versus the parent SBP verdict - Materials to obtain first: The selected subclaim has no score, status or axes fields. Do not fill them with parent scores or axes. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N02 · What outcomes are DBP and HRV? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Mittal covers 6-week SBP/DBP and HRV; Ghiya covers acute HRV. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Exact HRV measures, units and models and original DBP tables are unverified. Do not combine DBP and HRV into one effect. - Required materials and conditions: Outcome definitions, units, timing, denominators and analyses - Materials to obtain first: Exact HRV measures, units and models and original DBP tables are unverified. Do not combine DBP and HRV into one effect. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N03 · Are the populations the same? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Mittal is a standard-care adjunct trial in adults with hypertension on medication, with 91 randomized and 68 completed. Ghiya has an original 100 participants. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Ghiya eligibility/medication status and both trials' age and baseline DBP/HRV are unverified. Do not fill in the same hypertension population. - Required materials and conditions: Trial eligibility, age, baseline medication and pressure/HRV - Materials to obtain first: Ghiya eligibility/medication status and both trials' age and baseline DBP/HRV are unverified. Do not fill in the same hypertension population. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N04 · What combined program was studied? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Mittal added 2 minutes of abdominal breathing followed by 10 minutes of alternate-nostril breathing daily as a combined intervention. These identify the study and are not breathing instructions. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Actual intensity, adherence and incremental component contributions are unverified. Do not attribute effects to alternate-nostril breathing alone. - Required materials and conditions: Preceding breathing, components, actual delivery and adherence - Materials to obtain first: Actual intensity, adherence and incremental component contributions are unverified. Do not attribute effects to alternate-nostril breathing alone. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N05 · What was each control? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Mittal compares an addition to standard care retaining medication and lifestyle management; Ghiya is an acute comparison with another pranayama. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Arm contact, co-management and delivery details are unverified. Do not turn Ghiya's control into a 6-week standard-care control. - Required materials and conditions: Standard care, active control, contact and existing medication/lifestyle care - Materials to obtain first: Arm contact, co-management and delivery details are unverified. Do not turn Ghiya's control into a 6-week standard-care control. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N06 · Are observation periods and measurement windows the same? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Mittal 6-week and Ghiya acute HRV observations have different windows. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Detailed test timing is unverified. Do not count acute HRV as independent replication of 6-week pressure or long-term autonomic improvement. - Required materials and conditions: Outcome periods, measurement timing and follow-up - Materials to obtain first: Detailed test timing is unverified. Do not count acute HRV as independent replication of 6-week pressure or long-term autonomic improvement. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N07 · Are randomized, completed, withdrawn and analysis populations the same? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve original 91 randomized, 68 completed and parent-record 23 withdrawals/25.3% attrition. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Arm denominators for DBP/each HRV measure, withdrawal reasons and outcomes for all randomized participants are unverified. Calculate no new attrition rates or denominators. - Required materials and conditions: Outcome-specific arm denominators, missingness and withdrawal reasons - Materials to obtain first: Arm denominators for DBP/each HRV measure, withdrawal reasons and outcomes for all randomized participants are unverified. Calculate no new attrition rates or denominators. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N08 · What does null DBP mean? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve Mittal DBP P>.05 and the selected note's null DBP result. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Arm values, effects, CIs, exact P and models are unverified. Null does not mean exact effect 0 or equivalence. - Required materials and conditions: Arm DBP, between-group effects, CIs, exact P and models - Materials to obtain first: Arm values, effects, CIs, exact P and models are unverified. Null does not mean exact effect 0 or equivalence. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N09 · How did Mittal HRV vary by measure? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Original explanations and the selected note record HRV varying by metric and study. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Exact measures, values, effects, CIs, P and measurement conditions are unverified. Do not extend this to normalization of all HRV. - Required materials and conditions: Measure list, units, directions, denominators and between-group estimates - Materials to obtain first: Exact measures, values, effects, CIs, P and measurement conditions are unverified. Do not extend this to normalization of all HRV. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N10 · What was Ghiya's acute HRV result? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve Ghiya 100 participants, acute comparison with another pranayama and between-group null HRV. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Measures, units, arm denominators, baseline/final values, CIs, P and models are unverified. Do not transfer this into a 6-week HRV effect. - Required materials and conditions: Active control, measure-specific estimates, denominators and models - Materials to obtain first: Measures, units, arm denominators, baseline/final values, CIs, P and models are unverified. Do not transfer this into a 6-week HRV effect. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S02 ### N11 · Can parent SBP numbers be transferred? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: SBP 139.14±12.5 versus 147.79±12.8 mmHg, P<.01 and existing crude difference -8.65 mmHg are parent SBP context. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Do not turn SBP final values or existing arithmetic into DBP/HRV effects or adjusted changes. Calculate no new differences or CIs. - Required materials and conditions: SBP versus DBP/HRV and final values versus adjusted changes - Materials to obtain first: Do not turn SBP final values or existing arithmetic into DBP/HRV effects or adjusted changes. Calculate no new differences or CIs. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N12 · How did DBP/HRV analyses handle missingness and baseline values? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The parent record retains complete-case analysis and unverified adjusted between-group effects/CIs. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: DBP/each HRV measure's ITT/PP, missing-data handling, baseline adjustment, repeated models and sensitivity analyses are unverified. - Required materials and conditions: Outcome-specific ITT/PP, adjustment, repeated models and sensitivity - Materials to obtain first: DBP/each HRV measure's ITT/PP, missing-data handling, baseline adjustment, repeated models and sensitivity analyses are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N13 · Were allocation, blinding and evaluation roles verified? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve original designs described as a Mittal randomized adjunct trial and Ghiya acute comparison. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Allocation, concealment, evaluation/analysis roles and expectancy control are unverified. Do not fill in Ghiya as a newly established randomized trial. - Required materials and conditions: Allocation, concealment and participant/evaluator/analyst roles - Materials to obtain first: Allocation, concealment, evaluation/analysis roles and expectancy control are unverified. Do not fill in Ghiya as a newly established randomized trial. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N14 · Were pressure/HRV measurement conditions and quality verified? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Each report records pressure or HRV outcomes. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Devices, rest, measurement counts, HRV recording length, breathing conditions and quality/exclusion rules are unverified. Do not merge different measurement conditions. - Required materials and conditions: Devices, resting conditions, repeats and signal quality - Materials to obtain first: Devices, rest, measurement counts, HRV recording length, breathing conditions and quality/exclusion rules are unverified. Do not merge different measurement conditions. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N15 · Does registration wording establish prospective endpoints? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Mittal's original registration wording is CTRI/2023/11/059625; Ghiya says unverified. The parent record retains unverified formal prospective endpoints. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Registration, protocols, SAPs, measure hierarchy, multiplicity and changes are unread. An identifier alone does not verify prospective status; unverified does not mean unregistered. - Required materials and conditions: Registration, protocol, SAP, DBP/HRV hierarchy and changes - Materials to obtain first: Registration, protocols, SAPs, measure hierarchy, multiplicity and changes are unread. An identifier alone does not verify prospective status; unverified does not mean unregistered. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N16 · Were precision and clinical meaning across measures verified? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve null DBP and mixed HRV descriptions separately. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: 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. - Required materials and conditions: Planned comparisons, effects, CIs, important changes and sample planning - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N17 · Was this independently replicated under the same conditions? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Distinguish 6-week combined breathing from acute HRV with a different comparator. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Independent confirmation under the same DBP/HRV conditions and unique-trial/participant totals are unconfirmed. Do not simply add the two reports. - Required materials and conditions: Report/trial families and the same measures, periods and intervention/controls - Materials to obtain first: Independent confirmation under the same DBP/HRV conditions and unique-trial/participant totals are unconfirmed. Do not simply add the two reports. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N18 · How far can results be extended? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The parent text says it did not use results from other pranayama or combined yoga and distinguishes pressure/HRV from medication replacement and long-term events. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: 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. - Required materials and conditions: Combined/standalone, other breathing, surrogates and long-term events - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N19 · Were existing treatment and actual delivery effects verified? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Mittal added an intervention while retaining medication and lifestyle care. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Outcome-specific medication/changes, lifestyle factors, actual delivery and measurement-condition effects are unverified. Do not newly establish causes of change. - Required materials and conditions: Existing medication, changes, lifestyle, delivery and exposure at measurement - Materials to obtain first: Outcome-specific medication/changes, lifestyle factors, actual delivery and measurement-condition effects are unverified. Do not newly establish causes of change. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N20 · Were funding, products, employee authors and COI verified? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve Mittal's reported public/academic support and Ghiya's academic-study wording. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Product/training support, employee authors, COI and role/control details are unverified. Academic wording does not verify overall independence. - Required materials and conditions: Report-specific support and evaluation, analysis and publication roles - Materials to obtain first: Product/training support, employee authors, COI and role/control details are unverified. Academic wording does not verify overall independence. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N21 · Were harms and their collection verified? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve parent caution and original safety text. Null or improved outcomes do not become safety certification. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Arm harms, collection procedures, stopping, denominators and missing data are unverified. Create no new event rates or safety claims. - Required materials and conditions: Harm definitions, arm events, denominators, exposure time, stopping and missingness - Materials to obtain first: Arm harms, collection procedures, stopping, denominators and missing data are unverified. Create no new event rates or safety claims. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N22 · Does this answer long-term and vulnerable-group safety? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve original caution as historical context and create no new breathing, medication reduction/replacement or treatment instructions. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Long-term, vulnerable-group and existing-medication/other-cause harm data are unverified. Do not extend safety from limited samples. - Required materials and conditions: Long follow-up, vulnerable groups, concurrent exposure and existing treatment - Materials to obtain first: Long-term, vulnerable-group and existing-medication/other-cause harm data are unverified. Do not extend safety from limited samples. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N23 · How are existing verdicts and dates preserved? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve parent C with 50 points, unrecorded precision, original bilingual texts, 2026-09-07, empty correction/deliberation records and selected grade D/note. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: 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. - Required materials and conditions: Parent/subclaim original values, both languages, axes, dates and correction history - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ### N24 · Which materials were actually read? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Production used the complete stored JSON summaries and bibliography. Distinguish summary reading from unread external materials. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: External 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. - Required materials and conditions: Report-specific stored summaries, external papers, registration, plans and support - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01, S02 ## Evidence and sources ### S01 Mittal G, et al. An Exploratory Randomised Trial to Assess the Effect of Nadi Shodhan Pranayama as an Adjunct Versus Standard Non-pharmacological Management in Hypertensives. Ann Neurosci. 2025. PMID: 40242728. PMCID: PMC11996816. DOI: 10.1177/09727531251318810. [PubMed](https://pubmed.ncbi.nlm.nih.gov/40242728/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: SBP 139.14±12.5 vs 147.79±12.8, P<.01; DBP P>.05 Record level: A 6-week trial added combined breathing to medication and lifestyle care. Preserve DBP P>.05/null and HRV differences by metric. The 91 randomized, 68 completed and original 23 withdrawals/25.3% do not replace measure-specific analysis denominators. Exact DBP/HRV values, units, effects/95% CIs, denominators and models are unverified. Independent replication: Mittal SBP, DBP and HRV are measures from one stored report; Ghiya compares acute HRV with another pranayama. Independent confirmation with the same measures, timing, intervention/controls and unique-trial/participant totals are unverified. Repeated measures, randomized/completed/withdrawn participants and shared questions are not counted as new independent trials or participant totals. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Preserve original PubMed URL, PMID 40242728, PMCID PMC11996816 and DOI 10.1177/09727531251318810. The original registration wording is CTRI/2023/11/059625; this case has no recorded separate registration annotation. Do not turn CTRI into NCT or infer a new registration URL, prospective status or original-text reading. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 40242728, PMCID PMC11996816 and DOI 10.1177/09727531251318810. The original registration wording is CTRI/2023/11/059625; this case has no recorded separate registration annotation. Do not turn CTRI into NCT or infer a new registration URL, prospective status or original-text reading. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 40242728, PMCID PMC11996816 and DOI 10.1177/09727531251318810. The original registration wording is CTRI/2023/11/059625; this case has no recorded separate registration annotation. Do not turn CTRI into NCT or infer a new registration URL, prospective status or original-text reading. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 40242728, PMCID PMC11996816 and DOI 10.1177/09727531251318810. The original registration wording is CTRI/2023/11/059625; this case has no recorded separate registration annotation. Do not turn CTRI into NCT or infer a new registration URL, prospective status or original-text reading. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 40242728, PMCID PMC11996816 and DOI 10.1177/09727531251318810. The original registration wording is CTRI/2023/11/059625; this case has no recorded separate registration annotation. Do not turn CTRI into NCT or infer a new registration URL, prospective status or original-text reading. | | Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 40242728, PMCID PMC11996816 and DOI 10.1177/09727531251318810. The original registration wording is CTRI/2023/11/059625; this case has no recorded separate registration annotation. Do not turn CTRI into NCT or infer a new registration URL, prospective status or original-text reading. | ### S02 Ghiya S, et al. Comparison of the effects of Nadi Shodhana Pranayama and Bhramari Pranayama on heart rate variability. J Ayurveda Integr Med. 2023. PMID: 37499590. PMCID: PMC10388195. DOI: 10.1016/j.jaim.2023.100774. [PubMed](https://pubmed.ncbi.nlm.nih.gov/37499590/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: Between-group HRV was null Record level: Separate 100-participant acute HRV comparison with another pranayama; preserve the original between-group null result. This is not independent 6-week DBP/HRV replication; population, arm denominators, measure-specific effects/CIs, measurement conditions and report-family relationships are unverified. Independent replication: Mittal SBP, DBP and HRV are measures from one stored report; Ghiya compares acute HRV with another pranayama. Independent confirmation with the same measures, timing, intervention/controls and unique-trial/participant totals are unverified. Repeated measures, randomized/completed/withdrawn participants and shared questions are not counted as new independent trials or participant totals. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Preserve original PubMed URL, PMID 37499590, PMCID PMC10388195 and DOI 10.1016/j.jaim.2023.100774. The original evidence registration field says unverified; no separate registration annotation is recorded for this case. This does not establish no registration; no new identifier, URL, prospective status or original-text reading is inferred. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 37499590, PMCID PMC10388195 and DOI 10.1016/j.jaim.2023.100774. The original evidence registration field says unverified; no separate registration annotation is recorded for this case. This does not establish no registration; no new identifier, URL, prospective status or original-text reading is inferred. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 37499590, PMCID PMC10388195 and DOI 10.1016/j.jaim.2023.100774. The original evidence registration field says unverified; no separate registration annotation is recorded for this case. This does not establish no registration; no new identifier, URL, prospective status or original-text reading is inferred. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 37499590, PMCID PMC10388195 and DOI 10.1016/j.jaim.2023.100774. The original evidence registration field says unverified; no separate registration annotation is recorded for this case. This does not establish no registration; no new identifier, URL, prospective status or original-text reading is inferred. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 37499590, PMCID PMC10388195 and DOI 10.1016/j.jaim.2023.100774. The original evidence registration field says unverified; no separate registration annotation is recorded for this case. This does not establish no registration; no new identifier, URL, prospective status or original-text reading is inferred. | | Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 37499590, PMCID PMC10388195 and DOI 10.1016/j.jaim.2023.100774. The original evidence registration field says unverified; no separate registration annotation is recorded for this case. This does not establish no registration; no new identifier, URL, prospective status or original-text reading is inferred. | ## Review criteria and methods These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score. - M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. ## What the statuses mean - Met: A state used when required evidence is confirmed after user review. This production does not declare that review complete. - Partly verified: Some information in the stored summary is linked into the table. External comparison/content review is not complete. - Unverified: The article leaves this unverified, or required material is absent from the current stored summary. This is distinct from zero, absence or safety. - Review incomplete: User review pending. - Not reported: Not reported within the stored material actually read; not extended to the entire primary paper. - Inaccessible: Means an actual access failure. Access not attempted here is not assigned this state. - Not applicable: Not used as a substitute for an evidence gap. - Conflicting data: Requires an observed disagreement under the same comparison criteria; not automatically judged in this production. - Insufficient evidence for the conditions: Marks a gap in additional material required by the selected conditions; not a new efficacy grade. ## Change history 2026-10-18 · Public page/materials 1.0. Public pages and materials were prepared from the existing 24 items. No new clinical search, verification-status change or scoring was performed.