# Laughter Yoga × Treatment of Depressive or Anxiety Disorders · Evidence and Gaps Sheet Verdict 3005 · 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: 2026-10-19 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: The selection concerns treatment in patients with diagnosed depressive or anxiety disorders. The 4 currently preserved reports provide nonclinical context involving 120 healthy university students, nursing-student samples of 75 and 83, and 70 psychiatric nurses; they are not linked as direct treatment trials in patients with the selected diagnoses. Psychiatric nurses are an occupational sample. Diagnoses, eligibility, severity and patient denominators are unverified. - Ingredient, formulation and route: The parent program combines laughter, clapping, breathing, movement and group participation. Corresponding treatment aims, existing and concurrent treatments, instructors, actual exposure and adherence in diagnosed patients are unlinked in current material. Nonclinical programs are not reassigned as diagnosed-disorder treatment, and no new yoga, mental-health treatment or existing-treatment-change methods are provided. - Dose: Single-exposure, 5-week or 8-session programs and the parent program of 8 sessions of 30 minutes are nonclinical research observation conditions. They are not converted into psychiatric-treatment doses or individual practice methods. Actual intervention exposure, concurrent treatment, participation and adherence for the selected diagnoses are unverified. - Comparator: Parent no-intervention controls and insufficient active social controls, and Fujisawa's humorous video and reading, provide nonclinical context. Treatment comparators, active comparisons, concurrent treatment, contact and expectations in diagnosed patients are unverified. Video, breathing and social-participation findings are not converted into direct comparisons of diagnosed-disorder treatment. - Measured outcome: The selection is treatment of depressive or anxiety disorders, preserving the original English "or" wording. Original subclaim verdict '?' and absent separate score, status and assessment axes are retained. PSS, GHQ, burnout, well-being, self-efficacy, mental symptoms, cortisol and DHEA are not reassigned as direct diagnosed-treatment, remission, response, function or relapse outcomes. Corresponding direct outcomes are unlinked in current stored material. - Duration: Treatment duration, persistence, function, relapse and post-discontinuation follow-up for the selected diagnoses are unlinked in current material. Parent-program observation periods are distinguished from diagnosed-treatment follow-up. Short-term nonclinical symptom and biomarker results are not extended to long-term treatment or remission. - Questions outside this scope: Healthy student/nurse samples and psychiatric-workplace samples are not converted into patients diagnosed with depressive or anxiety disorders.; Self-reported stress, mental-symptom and well-being findings are not reassigned as diagnosed-treatment, remission, function or relapse outcomes.; Mixed cortisol/DHEA findings are not promoted to disorder treatment or confirmation of mechanism.; Parent-program exposure periods, frequencies and components are not converted into individual psychiatric-treatment doses.; Original '?' and absent separate score, status and axes are not filled with other grades, parent values or numbers from another subclaim explanation.; Sharing the same reports/cohorts across sheets does not create new independent trial, patient or event totals.; Nonclinical completion, measures and biomarkers are not converted into diagnosed-treatment safety or absence of long-term harms.; No new yoga, mental-health treatment or methods to replace or discontinue existing treatment are provided. ## Checklist items ### N01 · What are the selected treatment question and original verdict? Verification status: Partly verified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The selection is treatment of depressive or anxiety disorders, and the original subclaim verdict is '?'. The original explanation that the main populations were healthy students and nurses, not patients in diagnosed-disorder treatment trials, is retained. Parent C50 concerns nonclinical stress. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: The selection has no separate score, status or assessment axes. '?' is not replaced with another grade or the parent score. - Required materials and conditions: The existing subclaim, verdict and explanation versus parent stress context - Materials to obtain first: The selection has no separate score, status or assessment axes. '?' is not replaced with another grade or the parent score. - Further research: Material needed: The selection has no separate score, status or assessment axes. '?' is not replaced with another grade or the parent score. This records needed materials; no new research was executed. - Conditions for verification: Material for The existing subclaim, verdict and explanation versus parent stress context must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects The existing subclaim, verdict and explanation versus parent stress context with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N02 · How do diagnosed patients differ from nonclinical samples? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The original explanation lists nonclinical studies in 120 healthy university students, 75/83 nursing students and 70 psychiatric nurses, distinguishing them from treatment trials in psychiatric patients. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Diagnosis, eligibility, severity and direct treatment denominators for the selected disorders are unlinked in current stored material. Working in psychiatry or having measured mental symptoms is not converted into a diagnosed-patient population. - Required materials and conditions: Diagnosis, eligibility, baseline severity and patient denominators - Materials to obtain first: Diagnosis, eligibility, severity and direct treatment denominators for the selected disorders are unlinked in current stored material. Working in psychiatry or having measured mental symptoms is not converted into a diagnosed-patient population. - Further research: Material needed: Diagnosis, eligibility, severity and direct treatment denominators for the selected disorders are unlinked in current stored material. Working in psychiatry or having measured mental symptoms is not converted into a diagnosed-patient population. This records needed materials; no new research was executed. - Conditions for verification: Material for Diagnosis, eligibility, baseline severity and patient denominators must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Diagnosis, eligibility, baseline severity and patient denominators with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N03 · Were treatment outcomes for each disorder verified? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The Korean selection lists depression and anxiety disorders in parallel, while the original English wording is depressive or anxiety disorders. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Direct treatment outcomes, remission, function and prespecified assessment instruments for each diagnosis are unverified. General mental-symptom results do not fill these gaps. - Required materials and conditions: Diagnosis-specific treatment aims, symptoms, remission, function and relapse definitions - Materials to obtain first: Direct treatment outcomes, remission, function and prespecified assessment instruments for each diagnosis are unverified. General mental-symptom results do not fill these gaps. - Further research: Material needed: Direct treatment outcomes, remission, function and prespecified assessment instruments for each diagnosis are unverified. General mental-symptom results do not fill these gaps. This records needed materials; no new research was executed. - Conditions for verification: Material for Diagnosis-specific treatment aims, symptoms, remission, function and relapse definitions must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Diagnosis-specific treatment aims, symptoms, remission, function and relapse definitions with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S03 ### N04 · Was the combined program evaluated as treatment in diagnosed patients? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The original laughter-yoga program includes clapping, breathing, movement and group participation. This sheet does not provide yoga or mental-health treatment methods. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: The relevant intervention, existing treatment, actual exposure, adherence and evaluation for treatment purposes in diagnosed patients are unlinked in current stored material. - Required materials and conditions: Program components, existing treatment, instructors, exposure and adherence - Materials to obtain first: The relevant intervention, existing treatment, actual exposure, adherence and evaluation for treatment purposes in diagnosed patients are unlinked in current stored material. - Further research: Material needed: The relevant intervention, existing treatment, actual exposure, adherence and evaluation for treatment purposes in diagnosed patients are unlinked in current stored material. This records needed materials; no new research was executed. - Conditions for verification: Material for Program components, existing treatment, instructors, exposure and adherence must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Program components, existing treatment, instructors, exposure and adherence with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N05 · Are parent controls controls for disorder treatment? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The parent explanation retains no-intervention controls, insufficient active social controls and combined effects as limitations. Fujisawa's humorous video and reading are separate acute nonclinical comparators. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Treatment comparators, contact, expectations and concurrent-treatment correspondence in diagnosed patients are unverified. Video findings are not reassigned as confirmation of disorder treatment. - Required materials and conditions: Treatment comparators, active social controls and matched contact and expectations - Materials to obtain first: Treatment comparators, contact, expectations and concurrent-treatment correspondence in diagnosed patients are unverified. Video findings are not reassigned as confirmation of disorder treatment. - Further research: Material needed: Treatment comparators, contact, expectations and concurrent-treatment correspondence in diagnosed patients are unverified. Video findings are not reassigned as confirmation of disorder treatment. This records needed materials; no new research was executed. - Conditions for verification: Material for Treatment comparators, active social controls and matched contact and expectations must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Treatment comparators, active social controls and matched contact and expectations with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S04 ### N06 · Are PSS, GHQ and burnout findings diagnosed-treatment outcomes? Verification status: Partly verified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: Original parent results are retained: 70 participants, all completing at 35 versus 35, PSS/GHQ/burnout after 8 sessions, and PSS F(1,68)=251.56, P<.001, partial eta-squared=.787. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: These values are not used as depression/anxiety treatment effects, remission or patient denominators. Psychiatric nurses are not psychiatric patients. - Required materials and conditions: Nonclinical nurses' stress measures versus diagnosed-disorder treatment - Materials to obtain first: These values are not used as depression/anxiety treatment effects, remission or patient denominators. Psychiatric nurses are not psychiatric patients. - Further research: Material needed: These values are not used as depression/anxiety treatment effects, remission or patient denominators. Psychiatric nurses are not psychiatric patients. This records needed materials; no new research was executed. - Conditions for verification: Material for Nonclinical nurses' stress measures versus diagnosed-disorder treatment must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Nonclinical nurses' stress measures versus diagnosed-disorder treatment with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01 ### N07 · What context do well-being, PSS and conflicting statistics provide? Verification status: Partly verified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The original account retains 83 analyzed, 41 versus 42, coexisting abstract between-arm null and main-text multivariate F=10.69, P<.001, and retrospective registration. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: The conflict is not newly resolved or reassigned as a disorder-treatment effect. The relevant diagnoses and direct outcomes are unlinked in the current stored summary. - Required materials and conditions: Nonclinical endpoints, abstract/main-text tests and prespecification - Materials to obtain first: The conflict is not newly resolved or reassigned as a disorder-treatment effect. The relevant diagnoses and direct outcomes are unlinked in the current stored summary. - Further research: Material needed: The conflict is not newly resolved or reassigned as a disorder-treatment effect. The relevant diagnoses and direct outcomes are unlinked in the current stored summary. This records needed materials; no new research was executed. - Conditions for verification: Material for Nonclinical endpoints, abstract/main-text tests and prespecification must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Nonclinical endpoints, abstract/main-text tests and prespecification with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S02 ### N08 · Does a positive mental-symptom result establish treatment effects in diagnosed patients? Verification status: Partly verified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: Positive mental-symptom findings in 75 first-year nursing students are retained separately from mixed cortisol findings. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Positive mental-symptom findings are not converted into depression/anxiety diagnosis, treatment effects or remission. Instruments, original estimates and diagnostic data are unverified. - Required materials and conditions: Mental-symptom instruments, populations and evaluation for treatment purposes - Materials to obtain first: Positive mental-symptom findings are not converted into depression/anxiety diagnosis, treatment effects or remission. Instruments, original estimates and diagnostic data are unverified. - Further research: Material needed: Positive mental-symptom findings are not converted into depression/anxiety diagnosis, treatment effects or remission. Instruments, original estimates and diagnostic data are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Mental-symptom instruments, populations and evaluation for treatment purposes must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Mental-symptom instruments, populations and evaluation for treatment purposes with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S03 ### N09 · Do cortisol and DHEA establish disorder treatment? Verification status: Partly verified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: Ozturk's between-arm cortisol positivity in 3 of 8 sessions and Fujisawa's time change, video-related change and null DHEA finding are retained. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Biomarker changes are not reassigned as depression treatment, anxiety-disorder remission or confirmation of mechanism. Direct outcomes for the selected treatment are unverified in current material. - Required materials and conditions: Separate evidence for biomarkers, symptoms and diagnosed-disorder treatment - Materials to obtain first: Biomarker changes are not reassigned as depression treatment, anxiety-disorder remission or confirmation of mechanism. Direct outcomes for the selected treatment are unverified in current material. - Further research: Material needed: Biomarker changes are not reassigned as depression treatment, anxiety-disorder remission or confirmation of mechanism. Direct outcomes for the selected treatment are unverified in current material. This records needed materials; no new research was executed. - Conditions for verification: Material for Separate evidence for biomarkers, symptoms and diagnosed-disorder treatment must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Separate evidence for biomarkers, symptoms and diagnosed-disorder treatment with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S03, S04 ### N10 · Were allocation and blinding for the selected treatment verified? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: Randomized designs in the 4 reports and parent concerns about lack of blinding and combined instructor/assessor roles are preserved as nonclinical research context. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external 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, assessor blinding and diagnostic/outcome assessment data for the selected treatment are unlinked in current material. - Required materials and conditions: Diagnosed-patient allocation, concealment, independent assessment and analysis roles - Materials to obtain first: Allocation, concealment, assessor blinding and diagnostic/outcome assessment data for the selected treatment are unlinked in current material. - Further research: Material needed: Allocation, concealment, assessor blinding and diagnostic/outcome assessment data for the selected treatment are unlinked in current material. This records needed materials; no new research was executed. - Conditions for verification: Material for Diagnosed-patient allocation, concealment, independent assessment and analysis roles must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Diagnosed-patient allocation, concealment, independent assessment and analysis roles with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N11 · Are nonclinical samples used as treatment-analysis denominators? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The respective nonclinical labels are retained: all 70 completing, 83 analyzed, and total samples of 75 and 120. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: These counts are not used as disorder-treatment denominators. Direct-treatment analysis populations, missingness, baseline adjustment and repeated-data models are unverified. - Required materials and conditions: Diagnosed-patient allocation, completion, analysis and missing-data handling - Materials to obtain first: These counts are not used as disorder-treatment denominators. Direct-treatment analysis populations, missingness, baseline adjustment and repeated-data models are unverified. - Further research: Material needed: These counts are not used as disorder-treatment denominators. Direct-treatment analysis populations, missingness, baseline adjustment and repeated-data models are unverified. This records needed materials; no new research was executed. - Conditions for verification: Material for Diagnosed-patient allocation, completion, analysis and missing-data handling must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Diagnosed-patient allocation, completion, analysis and missing-data handling with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N12 · Can treatment effects, confidence intervals and clinical meaning be determined? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The original selected verdict '?' and explanation that these were not diagnosed-patient treatment trials are retained. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Direct clinical effects, confidence intervals, response, remission, clinical-importance criteria and sample plans are unverified in current material. No new effects, intervals or grades are created. - Required materials and conditions: Diagnosis-specific between-arm effects, response, remission, function and sample planning - Materials to obtain first: Direct clinical effects, confidence intervals, response, remission, clinical-importance criteria and sample plans are unverified in current material. No new effects, intervals or grades are created. - Further research: Material needed: Direct clinical effects, confidence intervals, response, remission, clinical-importance criteria and sample plans are unverified in current material. No new effects, intervals or grades are created. This records needed materials; no new research was executed. - Conditions for verification: Material for Diagnosis-specific between-arm effects, response, remission, function and sample planning must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Diagnosis-specific between-arm effects, response, remission, function and sample planning with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N13 · Does nonclinical registration establish prespecification for the selected treatment? Verification status: Partly verified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: Original records are retained: Bilgihan's NCT07015372 schedule-consistency concerns, Yaş's retrospective NCT06175936 registration, Fujisawa's UMIN000019409 and Ozturk's unverified registration. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Registration originals, protocols and analysis plans are unread and do not substitute for prespecification of the selected disorder treatment. Identifiers alone do not certify prespecification or treatment evidence. - Required materials and conditions: Each registration versus diagnosed-treatment plans - Materials to obtain first: Registration originals, protocols and analysis plans are unread and do not substitute for prespecification of the selected disorder treatment. Identifiers alone do not certify prespecification or treatment evidence. - Further research: Material needed: Registration originals, protocols and analysis plans are unread and do not substitute for prespecification of the selected disorder treatment. Identifiers alone do not certify prespecification or treatment evidence. This records needed materials; no new research was executed. - Conditions for verification: Material for Each registration versus diagnosed-treatment plans must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Each registration versus diagnosed-treatment plans with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N14 · Is program duration a psychiatric-treatment duration? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The original explanation records single-exposure, 5-week or 8-session nonclinical programs. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: These are not reassigned as psychiatric-treatment duration or dose. Long-term treatment, relapse, function and persistence after discontinuation are unlinked in current material. - Required materials and conditions: Diagnosed-treatment duration, persistence and function/relapse follow-up - Materials to obtain first: These are not reassigned as psychiatric-treatment duration or dose. Long-term treatment, relapse, function and persistence after discontinuation are unlinked in current material. - Further research: Material needed: These are not reassigned as psychiatric-treatment duration or dose. Long-term treatment, relapse, function and persistence after discontinuation are unlinked in current material. This records needed materials; no new research was executed. - Conditions for verification: Material for Diagnosed-treatment duration, persistence and function/relapse follow-up must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Diagnosed-treatment duration, persistence and function/relapse follow-up with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N15 · What about existing mental-health treatment and concurrent factors? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: Combined social-participation and breathing effects in nonclinical groups provide parent-explanation context. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Direct-treatment medication, counseling, concurrent treatment, changes, adherence and lifestyle factors are unverified. No new instructions to replace or discontinue existing treatment are created. - Required materials and conditions: Existing treatment, changes, concurrent treatment and attribution of combined effects - Materials to obtain first: Direct-treatment medication, counseling, concurrent treatment, changes, adherence and lifestyle factors are unverified. No new instructions to replace or discontinue existing treatment are created. - Further research: Material needed: Direct-treatment medication, counseling, concurrent treatment, changes, adherence and lifestyle factors are unverified. No new instructions to replace or discontinue existing treatment are created. This records needed materials; no new research was executed. - Conditions for verification: Material for Existing treatment, changes, concurrent treatment and attribution of combined effects must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Existing treatment, changes, concurrent treatment and attribution of combined effects with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N16 · Are shared reports independent replications of disorder treatment? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The 4 reports are shared with the cortisol sheet, but are not counted as new independent trials. Agreement in nonclinical symptom direction is not converted into replicated confirmation of disorder treatment. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Unique trial, participant and independent-replication totals are unverified; direct diagnosed-treatment material is unlinked in current records. - Required materials and conditions: Nonclinical reports and cohorts versus direct diagnosed-patient treatment trials - Materials to obtain first: Unique trial, participant and independent-replication totals are unverified; direct diagnosed-treatment material is unlinked in current records. - Further research: Material needed: Unique trial, participant and independent-replication totals are unverified; direct diagnosed-treatment material is unlinked in current records. This records needed materials; no new research was executed. - Conditions for verification: Material for Nonclinical reports and cohorts versus direct diagnosed-patient treatment trials must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Nonclinical reports and cohorts versus direct diagnosed-patient treatment trials with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N17 · What do support declarations and instructor/assessor roles establish? Verification status: Partly verified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: Bilgihan's declaration of no external funding or conflicts is retained alongside combined instructor/assessor roles. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Declarations are not promoted to absence of all support, independent confirmation or completed current external comparison. Support evidence for the selected treatment is also unverified in current material. - Required materials and conditions: External funding, conflicts, training support and author/assessor roles - Materials to obtain first: Declarations are not promoted to absence of all support, independent confirmation or completed current external comparison. Support evidence for the selected treatment is also unverified in current material. - Further research: Material needed: Declarations are not promoted to absence of all support, independent confirmation or completed current external comparison. Support evidence for the selected treatment is also unverified in current material. This records needed materials; no new research was executed. - Conditions for verification: Material for External funding, conflicts, training support and author/assessor roles must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects External funding, conflicts, training support and author/assessor roles with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01 ### N18 · Were funding, support and conflicts in other reports verified? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The original record that funding in Yaş, Ozturk and Fujisawa was unable to be verified is retained. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Evidence does not establish absence of support, independence, absence of employee authors or absence of conflicts. - Required materials and conditions: Report-specific funding, training support, employee authors and conflicts - Materials to obtain first: Evidence does not establish absence of support, independence, absence of employee authors or absence of conflicts. - Further research: Material needed: Evidence does not establish absence of support, independence, absence of employee authors or absence of conflicts. This records needed materials; no new research was executed. - Conditions for verification: Material for Report-specific funding, training support, employee authors and conflicts must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Report-specific funding, training support, employee authors and conflicts with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S02, S03, S04 ### N19 · What is known about the selected treatment's safety and missingness? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: Original parent Unknown safety and insufficient arm-specific adverse-event and long-term safety numbers are retained. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Diagnosed-patient harms evidence is unlinked in current material. Nonclinical completion, measures and biomarkers are not converted into treatment safety. - Required materials and conditions: Diagnosed-patient harms, discontinuation, denominators, collection and timing - Materials to obtain first: Diagnosed-patient harms evidence is unlinked in current material. Nonclinical completion, measures and biomarkers are not converted into treatment safety. - Further research: Material needed: Diagnosed-patient harms evidence is unlinked in current material. Nonclinical completion, measures and biomarkers are not converted into treatment safety. This records needed materials; no new research was executed. - Conditions for verification: Material for Diagnosed-patient harms, discontinuation, denominators, collection and timing must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Diagnosed-patient harms, discontinuation, denominators, collection and timing with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N20 · What are the boundaries for long-term harms, vulnerable populations, alternative causes and guidance? Verification status: Unverified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The parent safety explanation is retained as historical context, with no new yoga or mental-health treatment instructions. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Diagnosis-specific long-term and vulnerable-population evidence, treatment-change-related harms and alternative causes are unverified. Unknown is not converted into safe or no events. - Required materials and conditions: Diagnosis-specific long-term harms, concurrent exposure and alternative causes - Materials to obtain first: Diagnosis-specific long-term and vulnerable-population evidence, treatment-change-related harms and alternative causes are unverified. Unknown is not converted into safe or no events. - Further research: Material needed: Diagnosis-specific long-term and vulnerable-population evidence, treatment-change-related harms and alternative causes are unverified. Unknown is not converted into safe or no events. This records needed materials; no new research was executed. - Conditions for verification: Material for Diagnosis-specific long-term harms, concurrent exposure and alternative causes must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Diagnosis-specific long-term harms, concurrent exposure and alternative causes with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N21 · How are original languages, '?' verdict, parent axes and history retained? Verification status: Partly verified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: Parent C50, unspecified precision, Korean/English originals, evidence date 2026-09-07, an empty corrections list and empty deliberation are retained. Selected '?', the original explanation and absent separate score, status and axes are preserved. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Cortisol explanatory numbers, parent scores and axes and historical review are not inherited as new disorder-treatment values, current review or certification. - Required materials and conditions: Separate preservation of parent/subclaim structures, wording and dates - Materials to obtain first: Cortisol explanatory numbers, parent scores and axes and historical review are not inherited as new disorder-treatment values, current review or certification. - Further research: Material needed: Cortisol explanatory numbers, parent scores and axes and historical review are not inherited as new disorder-treatment values, current review or certification. This records needed materials; no new research was executed. - Conditions for verification: Material for Separate preservation of parent/subclaim structures, wording and dates must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Separate preservation of parent/subclaim structures, wording and dates with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ### N22 · What was actually read from stored summaries and external materials? Verification status: Partly verified Reading scope: Stored summary read; external papers, registration, protocols, analysis plans and support disclosures unread - Current findings: The complete stored parent summary and bibliography were read for this production. Material links, summary reading and unread external materials are distinguished. - Why unverified: Known nonclinical information and gaps concerning the selected diagnosed-disorder treatment were distinguished and transferred from the stored summary. Detailed external 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, analysis plans and support originals were unread and access was not attempted. URLs and historical verification statements are not promoted to current external reading or content verification. - Required materials and conditions: Report-specific originals, registration, plans, support and material-link status - Materials to obtain first: External papers, registration, protocols, analysis plans and support originals were unread and access was not attempted. URLs and historical verification statements are not promoted to current external reading or content verification. - Further research: Material needed: External papers, registration, protocols, analysis plans and support originals were unread and access was not attempted. URLs and historical verification statements are not promoted to current external reading or content verification. This records needed materials; no new research was executed. - Conditions for verification: Material for Report-specific originals, registration, plans, support and material-link status must be linked to the relevant diagnoses, treatment comparisons, outcomes and denominators, distinguishing currently stored nonclinical information from gaps in direct treatment evidence. - Why this condition is needed: This condition connects Report-specific originals, registration, plans, support and material-link status with the selected diagnoses, populations, treatment aims, interventions, concurrent treatment, comparators, outcomes, timing, denominators, prespecification, analyses or harms, distinguishing nonclinical parent reports. - Application exceptions: Retain original subclaim '?', its explanation and absent separate score/status/axes. Do not inherit parent C50, the cortisol explanation's 46-level wording or parent axes. Healthy students, nurses, psychiatric workplaces, mental symptoms and biomarkers are not converted into diagnosed patients, treatment or remission. Gaps in currently preserved reports are not extended to absence of research across all external literature or treatment success/failure. No new effects, CIs, grades, clinical totals, safety/independence certification, treatment methods or instructions to change existing treatment are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Gaps are not converted into treatment success, failure or absence of harm; original verdict '?' is retained. Original scores, axes and historical narratives are not used as new verdicts, current verification or independence certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, exposure, comparisons, reports versus trials, endpoints, denominators and harms were referenced. - Related sources: S01, S02, S03, S04 ## Evidence and sources ### S01 Bilgihan S, Dost A. The effect of laughter yoga on the general health status, perceived stress and burnout levels of psychiatric nurses: a randomized controlled study. Discover Psychology. 2026;6:200. DOI: 10.1007/s44202-026-00725-4. [Official source](https://doi.org/10.1007/s44202-026-00725-4) Materials actually read: Stored summary read; external materials unread Findings recorded in the summary: PSS group-by-time F(1,68)=251.56, P<.001, partial eta-squared .787; trial and registration dates raised timing concerns Record level: Nonclinical stress context: 70 psychiatric nurses, all completing at 35 versus 35, with PSS/GHQ/burnout after 8 sessions. Psychiatric nurses are not a diagnosed-patient sample; these statistics, denominators and durations are not reassigned as depression/anxiety treatment or remission. Independent replication: The parent and perceived-stress, cortisol and diagnosed-treatment questions share the four original reports. All four currently preserved reports provide nonclinical context and are not linked as direct treatment trials in patients with the selected diagnoses. Report-specific groups are retained, but unique trial, participant, independent-replication and event totals are unverified. Sheets, arms and sessions are not added as new treatment confirmation. | 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 DOI 10.1007/s44202-026-00725-4, NCT07015372 and timing concerns. PMID/PMCID are unrecorded. No-external-funding/COI declarations and combined instructor/assessor roles provide nonclinical parent context, not current full-text/registration verification or certification of diagnosed-treatment evidence. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original DOI 10.1007/s44202-026-00725-4, NCT07015372 and timing concerns. PMID/PMCID are unrecorded. No-external-funding/COI declarations and combined instructor/assessor roles provide nonclinical parent context, not current full-text/registration verification or certification of diagnosed-treatment evidence. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original DOI 10.1007/s44202-026-00725-4, NCT07015372 and timing concerns. PMID/PMCID are unrecorded. No-external-funding/COI declarations and combined instructor/assessor roles provide nonclinical parent context, not current full-text/registration verification or certification of diagnosed-treatment evidence. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original DOI 10.1007/s44202-026-00725-4, NCT07015372 and timing concerns. PMID/PMCID are unrecorded. No-external-funding/COI declarations and combined instructor/assessor roles provide nonclinical parent context, not current full-text/registration verification or certification of diagnosed-treatment evidence. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original DOI 10.1007/s44202-026-00725-4, NCT07015372 and timing concerns. PMID/PMCID are unrecorded. No-external-funding/COI declarations and combined instructor/assessor roles provide nonclinical parent context, not current full-text/registration verification or certification of diagnosed-treatment evidence. | | 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 DOI 10.1007/s44202-026-00725-4, NCT07015372 and timing concerns. PMID/PMCID are unrecorded. No-external-funding/COI declarations and combined instructor/assessor roles provide nonclinical parent context, not current full-text/registration verification or certification of diagnosed-treatment evidence. | ### S02 Yaş MA, et al. The effect of laughter yoga on well-being, perceived stress, and academic self-efficacy in nursing students: A randomized controlled trial. Appl Psychol Health Well Being. 2025;17:e12610. PMID: 39415513. PMCID: PMC11635907. DOI: 10.1111/aphw.12610. [PubMed](https://pubmed.ncbi.nlm.nih.gov/39415513/) Materials actually read: Stored summary read; external materials unread Findings recorded in the summary: A null between-group abstract statement coexisted with a multivariate interaction F=10.69, P<.001; registration was retrospective Record level: Nonclinical well-being, PSS and self-efficacy context: 83 nursing students analyzed, 41 versus 42. Abstract between-arm null, main-text multivariate interaction and retrospective-registration statements are retained together. The conflict is not newly resolved or converted into a selected-disorder treatment effect. Independent replication: The parent and perceived-stress, cortisol and diagnosed-treatment questions share the four original reports. All four currently preserved reports provide nonclinical context and are not linked as direct treatment trials in patients with the selected diagnoses. Report-specific groups are retained, but unique trial, participant, independent-replication and event totals are unverified. Sheets, arms and sessions are not added as new treatment confirmation. | 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 PMID 39415513, PMC11635907, DOI 10.1111/aphw.12610 and NCT06175936. Abstract/main-text conflict and retrospective registration are original narratives, not newly resolved. Support is unverified; these are not direct materials for treatment of the selected diagnoses. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 39415513, PMC11635907, DOI 10.1111/aphw.12610 and NCT06175936. Abstract/main-text conflict and retrospective registration are original narratives, not newly resolved. Support is unverified; these are not direct materials for treatment of the selected diagnoses. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 39415513, PMC11635907, DOI 10.1111/aphw.12610 and NCT06175936. Abstract/main-text conflict and retrospective registration are original narratives, not newly resolved. Support is unverified; these are not direct materials for treatment of the selected diagnoses. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 39415513, PMC11635907, DOI 10.1111/aphw.12610 and NCT06175936. Abstract/main-text conflict and retrospective registration are original narratives, not newly resolved. Support is unverified; these are not direct materials for treatment of the selected diagnoses. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 39415513, PMC11635907, DOI 10.1111/aphw.12610 and NCT06175936. Abstract/main-text conflict and retrospective registration are original narratives, not newly resolved. Support is unverified; these are not direct materials for treatment of the selected diagnoses. | | 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 PMID 39415513, PMC11635907, DOI 10.1111/aphw.12610 and NCT06175936. Abstract/main-text conflict and retrospective registration are original narratives, not newly resolved. Support is unverified; these are not direct materials for treatment of the selected diagnoses. | ### S03 Ozturk FO, Tezel A. Effect of laughter yoga on mental symptoms and salivary cortisol levels in first-year nursing students: A randomized controlled trial. Int J Nurs Pract. 2021;27:e12924. PMID: 33580606. DOI: 10.1111/ijn.12924. [PubMed](https://pubmed.ncbi.nlm.nih.gov/33580606/) Materials actually read: Stored summary read; external materials unread Findings recorded in the summary: Mental symptoms favored intervention; cortisol was between-group positive in only 3 of 8 sessions Record level: Nonclinical mental-symptom and cortisol context: 75 first-year nursing students over 8 sessions, with between-arm cortisol positivity in 3 of 8 sessions. Positive mental symptoms and session-specific biomarkers are distinguished and not reassigned as diagnosis, treatment or remission. Direct-treatment instruments, effects, CIs and patient denominators are unverified. Independent replication: The parent and perceived-stress, cortisol and diagnosed-treatment questions share the four original reports. All four currently preserved reports provide nonclinical context and are not linked as direct treatment trials in patients with the selected diagnoses. Report-specific groups are retained, but unique trial, participant, independent-replication and event totals are unverified. Sheets, arms and sessions are not added as new treatment confirmation. | 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 PMID 33580606 and DOI 10.1111/ijn.12924. PMCID is unrecorded; registration and support are unverified. Nonclinical mental symptoms and session-specific cortisol are not reassigned as diagnosed-disorder treatment; external originals and plans were unread in this work. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 33580606 and DOI 10.1111/ijn.12924. PMCID is unrecorded; registration and support are unverified. Nonclinical mental symptoms and session-specific cortisol are not reassigned as diagnosed-disorder treatment; external originals and plans were unread in this work. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 33580606 and DOI 10.1111/ijn.12924. PMCID is unrecorded; registration and support are unverified. Nonclinical mental symptoms and session-specific cortisol are not reassigned as diagnosed-disorder treatment; external originals and plans were unread in this work. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 33580606 and DOI 10.1111/ijn.12924. PMCID is unrecorded; registration and support are unverified. Nonclinical mental symptoms and session-specific cortisol are not reassigned as diagnosed-disorder treatment; external originals and plans were unread in this work. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 33580606 and DOI 10.1111/ijn.12924. PMCID is unrecorded; registration and support are unverified. Nonclinical mental symptoms and session-specific cortisol are not reassigned as diagnosed-disorder treatment; external originals and plans were unread in this work. | | 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 PMID 33580606 and DOI 10.1111/ijn.12924. PMCID is unrecorded; registration and support are unverified. Nonclinical mental symptoms and session-specific cortisol are not reassigned as diagnosed-disorder treatment; external originals and plans were unread in this work. | ### S04 Fujisawa A, et al. Effect of laughter yoga on salivary cortisol and dehydroepiandrosterone among healthy university students: A randomized controlled trial. Complement Ther Clin Pract. 2018;32:6-11. PMID: 30057059. DOI: 10.1016/j.ctcp.2018.04.005. [PubMed](https://pubmed.ncbi.nlm.nih.gov/30057059/) Materials actually read: Stored summary read; external materials unread Findings recorded in the summary: Cortisol changed over time, humorous video also changed it, and DHEA was null Record level: Acute 3-arm laughter-yoga, video and reading comparison in 120 healthy university students. Original cortisol change over time, change with video and null DHEA findings are retained. Acute biomarker comparisons are not converted into diagnosed-patient treatment, long-term remission or confirmation of mechanism. Independent replication: The parent and perceived-stress, cortisol and diagnosed-treatment questions share the four original reports. All four currently preserved reports provide nonclinical context and are not linked as direct treatment trials in patients with the selected diagnoses. Report-specific groups are retained, but unique trial, participant, independent-replication and event totals are unverified. Sheets, arms and sessions are not added as new treatment confirmation. | 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 PMID 30057059, DOI 10.1016/j.ctcp.2018.04.005 and UMIN000019409. PMCID is unrecorded; support and exact comparative CIs are unverified. UMIN is not relabeled as NCT, and acute comparisons/identifiers are not treated as diagnosed-treatment evidence or current registration-content verification. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 30057059, DOI 10.1016/j.ctcp.2018.04.005 and UMIN000019409. PMCID is unrecorded; support and exact comparative CIs are unverified. UMIN is not relabeled as NCT, and acute comparisons/identifiers are not treated as diagnosed-treatment evidence or current registration-content verification. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 30057059, DOI 10.1016/j.ctcp.2018.04.005 and UMIN000019409. PMCID is unrecorded; support and exact comparative CIs are unverified. UMIN is not relabeled as NCT, and acute comparisons/identifiers are not treated as diagnosed-treatment evidence or current registration-content verification. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 30057059, DOI 10.1016/j.ctcp.2018.04.005 and UMIN000019409. PMCID is unrecorded; support and exact comparative CIs are unverified. UMIN is not relabeled as NCT, and acute comparisons/identifiers are not treated as diagnosed-treatment evidence or current registration-content verification. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 30057059, DOI 10.1016/j.ctcp.2018.04.005 and UMIN000019409. PMCID is unrecorded; support and exact comparative CIs are unverified. UMIN is not relabeled as NCT, and acute comparisons/identifiers are not treated as diagnosed-treatment evidence or current registration-content verification. | | 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 PMID 30057059, DOI 10.1016/j.ctcp.2018.04.005 and UMIN000019409. PMCID is unrecorded; support and exact comparative CIs are unverified. UMIN is not relabeled as NCT, and acute comparisons/identifiers are not treated as diagnosed-treatment evidence or current registration-content verification. | ## 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 2026-10-19 · Public page/materials 1.0. Reader pages and materials were prepared from the existing 22 items. No new clinical search, change in verification status or scoring was performed.