# Buteyko for Adult Asthma × Preventing Exacerbations or Replacing Inhaled Therapy — Unproven · Evidence and Gaps Sheet Verdict 3007 · 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 stored materials concern adults with asthma. Report-specific populations of 39, 90 assigned and 69 completed, 129 assigned and 119 assessed, and 60 are kept in their respective contexts. Eligibility, severity, baseline exacerbation risk, medication doses and event-specific valid denominators are unverified. The parent representative population is not copied as the denominator for every report, and no new participant total is created. - Ingredient, formulation and route: The intervention is Buteyko breathing training added to standard inhaled care. Medication reduction under clinical review in the original summary is a study-care context, distinguished from evidence of complete replacement of inhaled therapy. Detailed teaching, actual practice, adherence and concurrent care are unverified; no personal breathing, medication-withdrawal or tapering instructions are created. - Dose: The preserved program names and teaching context are transferred. Quantified teaching, amounts of practice, actual exposure, medication doses, reduction criteria and monitoring procedures are unverified. Reduced medication use or voluntary control pause is not converted into an individual's optimal breathing amount, therapy replacement or tapering steps. - Comparator: Asthma education, sham devices, pranayama, active physiotherapist-led breathing education and usual care are distinguished by report. Original materials are needed to map contact, expectations, existing care and medication policies. Different comparisons are not pooled as the same exacerbation-prevention effect, and an adjunctive-training comparison is not assumed to compare complete withdrawal or replacement of standard inhaled care. - Measured outcome: The selection is prevention of asthma exacerbations or replacement of inhaled therapy, retaining original subclaim D and absent individual score, status and axes. Its original explanation of no exacerbation benefit and clinically supervised medication reduction is preserved. Cooper's null exacerbations and gaps in events, denominators and CIs are distinguished from reduced medication use, symptom or rescue-use signals, null primary asthma control and secondary ICS findings. Both outcomes are explained within the same subclaim without creating new independent claims, effects or equivalence conclusions. - Duration: Bowler's 3 months, Cowie's 6 months and the parent's trial-specific range of several weeks to 6 months are distinguished. Exact measurement windows for other reports, outcomes and medication policies are unverified. The same period is not copied to every exacerbation or harm, nor extended into long-term prevention, hospitalization, emergency care, or the persistence and safety of therapy replacement. - Questions outside this scope: Symptom or rescue-use signals and reduced medication use are not used as evidence of exacerbation prevention, complete replacement of inhaled therapy or cure.; Primary, co-primary and secondary outcomes, missing-data sensitivity, arm- and event-specific denominators and timing are distinguished.; Null exacerbations are distinguished from gaps in exact effects and CIs; an effect of 0, equivalence or a new grade is not established.; Comparisons with breathing education, sham devices, pranayama, active education and usual care are not pooled as the same therapy-replacement comparison.; Samples, assigned or completed populations, medication denominators and shared reports are not summed into new participant, event, attrition or independent-replication totals.; Registration identifiers, historical access, support or COI checks and original material dates are not labeled as current external reading or verification of prespecification.; Study reductions under clinical supervision and limited observation are not converted into personal inhaler withdrawal, therapy replacement, breathing steps, acute-attack management or long-term safety guidance. ## Checklist items ### N01 · What are the selected exacerbation-prevention and inhaled-therapy-replacement question and the parent verdict? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The selection concerns prevention of asthma exacerbations or replacement of inhaled therapy, with original subclaim D. Its explanation retains no improvement in exacerbations and clinically supervised medication reductions. Parent C50 concerns a different question about symptoms and rescue use. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: The selection has no separate score, status or axes. Original structure and authorized change records are needed; missing fields are not filled with parent values. - Required materials and conditions: Selected claim, original grade and explanation versus the parent symptom and rescue-use context - Materials to obtain first: The selection has no separate score, status or axes. Original structure and authorized change records are needed; missing fields are not filled with parent values. - Further research: Material needed: The selection has no separate score, status or axes. Original structure and authorized change records are needed; missing fields are not filled with parent values. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Selected claim, original grade and explanation versus the parent symptom and rescue-use context must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Selected claim, original grade and explanation versus the parent symptom and rescue-use context with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ### N02 · Are exacerbation prevention and inhaled-therapy replacement the same outcome? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The existing Korean question combines exacerbation prevention and inhaled-therapy replacement; English records prevention or replacement. Reduced medication use is distinguished from complete replacement. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original plans are needed for exacerbation definitions, the target replacement effect, whether complete withdrawal occurred and comparator conditions. No personal medication-withdrawal or tapering instructions are created. - Required materials and conditions: Separate definitions of exacerbation events, therapy replacement and medication reduction - Materials to obtain first: Original plans are needed for exacerbation definitions, the target replacement effect, whether complete withdrawal occurred and comparator conditions. No personal medication-withdrawal or tapering instructions are created. - Further research: Material needed: Original plans are needed for exacerbation definitions, the target replacement effect, whether complete withdrawal occurred and comparator conditions. No personal medication-withdrawal or tapering instructions are created. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Separate definitions of exacerbation events, therapy replacement and medication reduction must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Separate definitions of exacerbation events, therapy replacement and medication reduction with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ### N03 · Which adults with asthma do the findings concern? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original report-specific contexts retain 39 adults, 90 randomized and 69 completed, 129 assigned and 119 assessed at 6 months, and 60 adults separately. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Trial-specific eligibility, baseline exacerbation risk, ICS doses and control levels are needed. The parent representative population is not used as the denominator for every trial or event, and no new total is calculated. - Required materials and conditions: Diagnosis, severity, baseline medication, recent exacerbations, age and eligibility - Materials to obtain first: Trial-specific eligibility, baseline exacerbation risk, ICS doses and control levels are needed. The parent representative population is not used as the denominator for every trial or event, and no new total is calculated. - Further research: Material needed: Trial-specific eligibility, baseline exacerbation risk, ICS doses and control levels are needed. The parent representative population is not used as the denominator for every trial or event, and no new total is calculated. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Diagnosis, severity, baseline medication, recent exacerbations, age and eligibility must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Diagnosis, severity, baseline medication, recent exacerbations, age and eligibility with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ### N04 · Which adjunctive Buteyko training was studied? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original summary concerns Buteyko education added to adult asthma care. General breathing retraining or pranayama is not pooled as the same intervention. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Teaching, contact time, amounts of practice, adherence and trial-specific manuals are needed. Study descriptions are not converted into new breathing-practice instructions. - Required materials and conditions: Instructors, programs, contact, actual practice and existing care - Materials to obtain first: Teaching, contact time, amounts of practice, adherence and trial-specific manuals are needed. Study descriptions are not converted into new breathing-practice instructions. - Further research: Material needed: Teaching, contact time, amounts of practice, adherence and trial-specific manuals are needed. Study descriptions are not converted into new breathing-practice instructions. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Instructors, programs, contact, actual practice and existing care must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Instructors, programs, contact, actual practice and existing care with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ### N05 · Are contact, expectations and background care the same across comparators? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original summary distinguishes different comparators. Cooper has 3 arms of Buteyko, pranayama and placebo; Cowie uses physiotherapist-led breathing education, and Vagedes uses usual care. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original materials are needed for teaching, contact, expectations and existing care for each comparator. Different comparisons are not pooled as one exacerbation-prevention or therapy-replacement effect. - Required materials and conditions: Mappings for education, sham devices, pranayama, active education and usual care - Materials to obtain first: Original materials are needed for teaching, contact, expectations and existing care for each comparator. Different comparisons are not pooled as one exacerbation-prevention or therapy-replacement effect. - Further research: Material needed: Original materials are needed for teaching, contact, expectations and existing care for each comparator. Different comparisons are not pooled as one exacerbation-prevention or therapy-replacement effect. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Mappings for education, sham devices, pranayama, active education and usual care must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Mappings for education, sham devices, pranayama, active education and usual care with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S02, S03, S04 ### N06 · Have allocation, masking and exacerbation assessment been verified? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: Bowler's blinded-trial label and the randomized-trial descriptions of other reports are preserved. The original summary retains difficulties with masking the intervention and lack of masking as limitations. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Trial-specific allocation concealment, masking roles and independent exacerbation-assessment procedures are needed. Design labels are not treated as completed review of every bias domain. - Required materials and conditions: Allocation, concealment and masking of participants, assessors and analysts - Materials to obtain first: Trial-specific allocation concealment, masking roles and independent exacerbation-assessment procedures are needed. Design labels are not treated as completed review of every bias domain. - Further research: Material needed: Trial-specific allocation concealment, masking roles and independent exacerbation-assessment procedures are needed. Design labels are not treated as completed review of every bias domain. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Allocation, concealment and masking of participants, assessors and analysts must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Allocation, concealment and masking of participants, assessors and analysts with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ### N07 · What is established by Cooper's null exacerbation finding? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: Cooper's original endpoints include exacerbations, and the results record null objective measures, exacerbations and ICS. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original tables are needed for exacerbation event counts, arm-specific denominators, definitions, follow-up, estimates and CIs. A null finding does not establish an effect of 0 or equivalence. - Required materials and conditions: Exacerbation definitions, event counts, arm-specific denominators, observation time, effects and CIs - Materials to obtain first: Original tables are needed for exacerbation event counts, arm-specific denominators, definitions, follow-up, estimates and CIs. A null finding does not establish an effect of 0 or equivalence. - Further research: Material needed: Original tables are needed for exacerbation event counts, arm-specific denominators, definitions, follow-up, estimates and CIs. A null finding does not establish an effect of 0 or equivalence. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Exacerbation definitions, event counts, arm-specific denominators, observation time, effects and CIs must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Exacerbation definitions, event counts, arm-specific denominators, observation time, effects and CIs with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S02 ### N08 · What is the hierarchy of symptom co-primary outcomes and exacerbations? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The parent retains symptom co-primary signals alongside null airway responsiveness in the trial of 90 participants. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original plans, endpoint lists, analysis plans and records of exacerbation hierarchy, multiplicity and changes are needed. Symptom signals are not reassigned as successful exacerbation prevention. - Required materials and conditions: The prespecified relationship of symptom and PD20 co-primary outcomes to exacerbations - Materials to obtain first: Original plans, endpoint lists, analysis plans and records of exacerbation hierarchy, multiplicity and changes are needed. Symptom signals are not reassigned as successful exacerbation prevention. - Further research: Material needed: Original plans, endpoint lists, analysis plans and records of exacerbation hierarchy, multiplicity and changes are needed. Symptom signals are not reassigned as successful exacerbation prevention. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for The prespecified relationship of symptom and PD20 co-primary outcomes to exacerbations must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links The prespecified relationship of symptom and PD20 co-primary outcomes to exacerbations with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S02 ### N09 · What do Cooper's 90 participants, 69 completers and missingness mean? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original 90 randomized and 69 completed are retained alongside the parent's 23% attrition wording. No new attrition or event rate is calculated. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original records are needed for completion by arm, exacerbation-analysis denominators, missingness, withdrawal reasons and assignment-based versus completer analyses. - Required materials and conditions: Assignment, completion, arm-specific analysis, missing exacerbations and analysis populations - Materials to obtain first: Original records are needed for completion by arm, exacerbation-analysis denominators, missingness, withdrawal reasons and assignment-based versus completer analyses. - Further research: Material needed: Original records are needed for completion by arm, exacerbation-analysis denominators, missingness, withdrawal reasons and assignment-based versus completer analyses. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Assignment, completion, arm-specific analysis, missing exacerbations and analysis populations must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Assignment, completion, arm-specific analysis, missing exacerbations and analysis populations with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S02 ### N10 · Are Bowler's rescue-use and ICS findings the same? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: In 39 adults, median beta2-agonist reductions of 904 versus 57 mcg, P=.002, are distinguished from ICS P=.06. These do not confirm replacement of inhaled therapy. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Materials are needed for arm mappings, units, analysis rules, ICS effects and CIs, complete replacement, exacerbations and tapering policies. Median differences are not newly calculated. - Required materials and conditions: Original beta2-agonist and ICS findings and tapering policies - Materials to obtain first: Materials are needed for arm mappings, units, analysis rules, ICS effects and CIs, complete replacement, exacerbations and tapering policies. Median differences are not newly calculated. - Further research: Material needed: Materials are needed for arm mappings, units, analysis rules, ICS effects and CIs, complete replacement, exacerbations and tapering policies. Median differences are not newly calculated. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Original beta2-agonist and ICS findings and tapering policies must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Original beta2-agonist and ICS findings and tapering policies with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01 ### N11 · How are Cooper's symptoms and rescue use distinguished from ICS and exacerbations? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: Symptom medians of -3 versus -1 versus 0, P=.003, and bronchodilator -2 puffs/day, P=.005, are preserved separately from null exacerbations and ICS. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Direct CIs, arm mappings, denominators and original plans are needed for each outcome. Symptom and rescue-use figures are not used as exacerbation event counts, ICS-replacement effects or cure. - Required materials and conditions: Values, denominators and prespecified hierarchy for each arm and outcome - Materials to obtain first: Direct CIs, arm mappings, denominators and original plans are needed for each outcome. Symptom and rescue-use figures are not used as exacerbation event counts, ICS-replacement effects or cure. - Further research: Material needed: Direct CIs, arm mappings, denominators and original plans are needed for each outcome. Symptom and rescue-use figures are not used as exacerbation event counts, ICS-replacement effects or cure. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Values, denominators and prespecified hierarchy for each arm and outcome must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Values, denominators and prespecified hierarchy for each arm and outcome with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S02 ### N12 · What are Cowie's primary asthma-control and secondary ICS findings? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: Control at 6 months of 79% versus 72%, P=.4, missing-as-failure findings of 68% versus 70%, P=.7, and ICS reduction of 23/56 versus 13/63, P=.02, are preserved separately. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Materials are needed for exacerbations, the extent of tapering, direct CIs and prespecified rules. Secondary ICS signals are not promoted into success on primary control or complete replacement of inhaled therapy. - Required materials and conditions: Primary findings, missing-data sensitivity and secondary ICS against active education - Materials to obtain first: Materials are needed for exacerbations, the extent of tapering, direct CIs and prespecified rules. Secondary ICS signals are not promoted into success on primary control or complete replacement of inhaled therapy. - Further research: Material needed: Materials are needed for exacerbations, the extent of tapering, direct CIs and prespecified rules. Secondary ICS signals are not promoted into success on primary control or complete replacement of inhaled therapy. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Primary findings, missing-data sensitivity and secondary ICS against active education must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Primary findings, missing-data sensitivity and secondary ICS against active education with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S03 ### N13 · What do Cowie's 129 participants, 119 assessed and arm-specific withdrawals mean? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original 129 assigned and 119 assessed at 6 months are retained alongside the bibliography's wording of imbalanced withdrawals by arm. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Materials are needed for arm-specific allocation, missingness, outcome-denominator relationships and missing taper-safety information. The original missing-as-failure sensitivity is not reproduced as a new analysis, and population differences are not calculated. - Required materials and conditions: Denominators for assignment, assessment and secondary outcomes, and missingness by arm - Materials to obtain first: Materials are needed for arm-specific allocation, missingness, outcome-denominator relationships and missing taper-safety information. The original missing-as-failure sensitivity is not reproduced as a new analysis, and population differences are not calculated. - Further research: Material needed: Materials are needed for arm-specific allocation, missingness, outcome-denominator relationships and missing taper-safety information. The original missing-as-failure sensitivity is not reproduced as a new analysis, and population differences are not calculated. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Denominators for assignment, assessment and secondary outcomes, and missingness by arm must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Denominators for assignment, assessment and secondary outcomes, and missingness by arm with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S03 ### N14 · What are Vagedes's primary and secondary findings and objective measures? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original summary of 60 adults records primary and some secondary signals alongside null FEV1 and FeNO and registration after recruitment. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Direct events and designs for exacerbation prevention and inhaled-therapy replacement, original plans and medication policies are needed. Control pause, ACQ and medication findings are not converted into confirmation of the selected question. - Required materials and conditions: Distinguishing voluntary control pause, ACQ and medication from FEV1 and FeNO - Materials to obtain first: Direct events and designs for exacerbation prevention and inhaled-therapy replacement, original plans and medication policies are needed. Control pause, ACQ and medication findings are not converted into confirmation of the selected question. - Further research: Material needed: Direct events and designs for exacerbation prevention and inhaled-therapy replacement, original plans and medication policies are needed. Control pause, ACQ and medication findings are not converted into confirmation of the selected question. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Distinguishing voluntary control pause, ACQ and medication from FEV1 and FeNO must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Distinguishing voluntary control pause, ACQ and medication from FEV1 and FeNO with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S04 ### N15 · What do NCT03098849 and post-recruitment registration mean? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: Vagedes's original evidence and bibliography contain NCT03098849, and the results describe registration after recruitment. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original registration, recruitment and registration dates, changes and analysis plans are unread. Preserving an identifier is not labeled as verification of prespecification or new external reading. - Required materials and conditions: Registration identifiers, timing, original plans and change history - Materials to obtain first: Original registration, recruitment and registration dates, changes and analysis plans are unread. Preserving an identifier is not labeled as verification of prespecification or new external reading. - Further research: Material needed: Original registration, recruitment and registration dates, changes and analysis plans are unread. Preserving an identifier is not labeled as verification of prespecification or new external reading. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Registration identifiers, timing, original plans and change history must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Registration identifiers, timing, original plans and change history with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S04 ### N16 · What does registration wording for the other trials mean? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: Bowler and Cooper's preregistry-era wording and Cowie's unverified-registration wording are preserved as original records. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original plans, registration or historical documents are needed. Historical statements of absence or uncertainty are not converted into completed new registry searches or content verification. - Required materials and conditions: Distinguishing historical registration fields from current content verification - Materials to obtain first: Original plans, registration or historical documents are needed. Historical statements of absence or uncertainty are not converted into completed new registry searches or content verification. - Further research: Material needed: Original plans, registration or historical documents are needed. Historical statements of absence or uncertainty are not converted into completed new registry searches or content verification. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Distinguishing historical registration fields from current content verification must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Distinguishing historical registration fields from current content verification with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03 ### N17 · What is the context of standard inhaled care and clinically supervised reduction? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original summary records adjunctive training added to standard inhaled care and medication reduction under clinical review. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original materials are needed for medications, doses, reduction criteria, monitoring, complete withdrawal and replacement comparisons. The study context is not converted into personal medication-replacement or tapering instructions. - Required materials and conditions: Existing care, clinical review and the extent of reduction within studies - Materials to obtain first: Original materials are needed for medications, doses, reduction criteria, monitoring, complete withdrawal and replacement comparisons. The study context is not converted into personal medication-replacement or tapering instructions. - Further research: Material needed: Original materials are needed for medications, doses, reduction criteria, monitoring, complete withdrawal and replacement comparisons. The study context is not converted into personal medication-replacement or tapering instructions. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Existing care, clinical review and the extent of reduction within studies must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Existing care, clinical review and the extent of reduction within studies with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ### N18 · Have precision and clinical meaning for exacerbation prevention been established? Verification status: Unverified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original account and subclaim explanation of null exacerbations and unproven prevention are retained. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Direct exacerbation effects, CIs, event denominators, sample plans and original severity-specific results are needed. No new relative risk, incidence or CI is calculated. - Required materials and conditions: Between-arm exacerbation effects, CIs, event denominators, severity and sample planning - Materials to obtain first: Direct exacerbation effects, CIs, event denominators, sample plans and original severity-specific results are needed. No new relative risk, incidence or CI is calculated. - Further research: Material needed: Direct exacerbation effects, CIs, event denominators, sample plans and original severity-specific results are needed. No new relative risk, incidence or CI is calculated. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Between-arm exacerbation effects, CIs, event denominators, severity and sample planning must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Between-arm exacerbation effects, CIs, event denominators, severity and sample planning with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S02 ### N19 · How are airway function, symptoms and exacerbations distinguished? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original summary separately records repeated null objective findings and some symptom and rescue-use signals. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original materials, exact values, clinical events and analysis tables are needed for each outcome. Symptom signals are not reassigned as evidence of improved airway function, exacerbation prevention or inhaled-therapy replacement. - Required materials and conditions: Separate FEV1, PEF, PD20, FeNO, symptom and exacerbation findings - Materials to obtain first: Original materials, exact values, clinical events and analysis tables are needed for each outcome. Symptom signals are not reassigned as evidence of improved airway function, exacerbation prevention or inhaled-therapy replacement. - Further research: Material needed: Original materials, exact values, clinical events and analysis tables are needed for each outcome. Symptom signals are not reassigned as evidence of improved airway function, exacerbation prevention or inhaled-therapy replacement. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Separate FEV1, PEF, PD20, FeNO, symptom and exacerbation findings must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Separate FEV1, PEF, PD20, FeNO, symptom and exacerbation findings with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S04 ### N20 · Do several weeks to 6 months answer long-term prevention or replacement questions? Verification status: Unverified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: Bowler's 3 months, Cowie's 6 months and the parent's trial-specific range of several weeks to 6 months are preserved separately. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Direct materials are needed for long-term exacerbations, hospitalization, emergency care, and safety and persistence of therapy replacement. The same observation period is not copied to every outcome or harm. - Required materials and conditions: Trial-specific periods, persistence, long-term exacerbations and therapy outcomes - Materials to obtain first: Direct materials are needed for long-term exacerbations, hospitalization, emergency care, and safety and persistence of therapy replacement. The same observation period is not copied to every outcome or harm. - Further research: Material needed: Direct materials are needed for long-term exacerbations, hospitalization, emergency care, and safety and persistence of therapy replacement. The same observation period is not copied to every outcome or harm. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Trial-specific periods, persistence, long-term exacerbations and therapy outcomes must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Trial-specific periods, persistence, long-term exacerbations and therapy outcomes with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S03, S04 ### N21 · Have independent replication, heterogeneity and shared reports been established? Verification status: Unverified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The 4 reports from different periods and comparators are preserved. Agreement in symptom direction is not converted into independent confirmation of the selected exacerbation or replacement question. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Independent materials under matching questions and analysis conditions, cohorts, plans, support and full results are needed. Unique trial, participant and independent-replication totals are not established or summed. - Required materials and conditions: Matching comparisons, exacerbation and replacement outcomes, support and population relationships - Materials to obtain first: Independent materials under matching questions and analysis conditions, cohorts, plans, support and full results are needed. Unique trial, participant and independent-replication totals are not established or summed. - Further research: Material needed: Independent materials under matching questions and analysis conditions, cohorts, plans, support and full results are needed. Unique trial, participant and independent-replication totals are not established or summed. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Matching comparisons, exacerbation and replacement outcomes, support and population relationships must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Matching comparisons, exacerbation and replacement outcomes, support and population relationships with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ### N22 · Are Bowler and Cooper's funding, support and interests known? Verification status: Unverified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original evidence records that specific funding and COI for both reports are unverified. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original funding, support, affiliations, interests and analysis-role materials are needed for each report. Uncertainty is not filled in as independent funding, absent support or absent interests. - Required materials and conditions: Funding, product and teaching support, employee authors, interests and roles - Materials to obtain first: Original funding, support, affiliations, interests and analysis-role materials are needed for each report. Uncertainty is not filled in as independent funding, absent support or absent interests. - Further research: Material needed: Original funding, support, affiliations, interests and analysis-role materials are needed for each report. Uncertainty is not filled in as independent funding, absent support or absent interests. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Funding, product and teaching support, employee authors, interests and roles must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Funding, product and teaching support, employee authors, interests and roles with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02 ### N23 · Does Cowie's anonymous donation verify independence? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original summary retains Cowie's anonymous donor and unverified independence. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original documents are needed for donor identity, support, affiliations, COI and control over the study. Anonymous donations are not established as independent funding. - Required materials and conditions: Donors, teaching support, authorship, analysis roles and control - Materials to obtain first: Original documents are needed for donor identity, support, affiliations, COI and control over the study. Anonymous donations are not established as independent funding. - Further research: Material needed: Original documents are needed for donor identity, support, affiliations, COI and control over the study. Anonymous donations are not established as independent funding. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Donors, teaching support, authorship, analysis roles and control must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Donors, teaching support, authorship, analysis roles and control with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S03 ### N24 · What do Vagedes's public or institutional support and historical checks mean? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: Original wording about public or institutional support and detailed full-text COI checks is preserved as a historical record. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: External funding, affiliation, COI and role materials are unread in this work. Historical checks are not inherited as current reading, completed review or certification of independence. - Required materials and conditions: Original support and COI wording versus materials actually read in this work - Materials to obtain first: External funding, affiliation, COI and role materials are unread in this work. Historical checks are not inherited as current reading, completed review or certification of independence. - Further research: Material needed: External funding, affiliation, COI and role materials are unread in this work. Historical checks are not inherited as current reading, completed review or certification of independence. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Original support and COI wording versus materials actually read in this work must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Original support and COI wording versus materials actually read in this work with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S04 ### N25 · Have harms related to reduction or acute exacerbations been established? Verification status: Unverified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The original context of supervised medication adjustment and safety cautions is retained. No new breathing, therapy-replacement or tapering instructions are written. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Trial-specific adverse events, denominators, observation times, discontinuation, safety monitoring and missingness are needed. General caution wording is not converted into absent events or harm incidence. - Required materials and conditions: Harm definitions, events, denominators, timing, monitoring and discontinuation - Materials to obtain first: Trial-specific adverse events, denominators, observation times, discontinuation, safety monitoring and missingness are needed. General caution wording is not converted into absent events or harm incidence. - Further research: Material needed: Trial-specific adverse events, denominators, observation times, discontinuation, safety monitoring and missingness are needed. General caution wording is not converted into absent events or harm incidence. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Harm definitions, events, denominators, timing, monitoring and discontinuation must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Harm definitions, events, denominators, timing, monitoring and discontinuation with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ### N26 · What is known about concurrent care, comparative harms and other populations? Verification status: Unverified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The parent caution verdict and the scope of adjunctive standard-care studies are preserved. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Comparator-specific harms, concurrent exposures, alternative causes and direct acute, high-risk and long-term materials are needed. These are not converted into treatment-safety certification or new management guidance. - Required materials and conditions: Existing medication, training exposure, comparator-specific harms and long-term risks - Materials to obtain first: Comparator-specific harms, concurrent exposures, alternative causes and direct acute, high-risk and long-term materials are needed. These are not converted into treatment-safety certification or new management guidance. - Further research: Material needed: Comparator-specific harms, concurrent exposures, alternative causes and direct acute, high-risk and long-term materials are needed. These are not converted into treatment-safety certification or new management guidance. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Existing medication, training exposure, comparator-specific harms and long-term risks must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Existing medication, training exposure, comparator-specific harms and long-term risks with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ### N27 · How are parent axes, bilingual wording, dates and corrections retained? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: Parent C50, split co-primary and failed-primary-positive-secondary flags, bilingual wording, 2026-09-07 and empty correction lists and reasons are preserved in the original. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Original records and authorized correction events are needed. Parent values or historical checks are not inherited as subclaim scores, axes, new judgments or completed current content review. - Required materials and conditions: Distinguishing parent grade and axes from selected D and absent fields - Materials to obtain first: Original records and authorized correction events are needed. Parent values or historical checks are not inherited as subclaim scores, axes, new judgments or completed current content review. - Further research: Material needed: Original records and authorized correction events are needed. Parent values or historical checks are not inherited as subclaim scores, axes, new judgments or completed current content review. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Distinguishing parent grade and axes from selected D and absent fields must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Distinguishing parent grade and axes from selected D and absent fields with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ### N28 · Is reading the stored summary the same as reading external materials? Verification status: Partly verified Reading scope: Stored summary read; external papers, abstracts, full texts, registration, protocols, analysis plans and support materials unread - Current findings: The complete stored review summary and bibliography were used for production. Summary reading is distinguished from unread external materials and bibliographic links. - Why unverified: Information was transferred from the stored summary while distinguishing the existing selected question from parent material. Detailed originals are unverified and review of existing content remains incomplete. This does not establish clinical certification or a passed content review. - Reason for missing information: Actual acquisition and reading of external papers, registration, plans and support materials are needed. Historical-check wording, URLs and original material dates alone do not raise verification status. - Required materials and conditions: Access status of originals, registration, protocols, analysis plans and support by report - Materials to obtain first: Actual acquisition and reading of external papers, registration, plans and support materials are needed. Historical-check wording, URLs and original material dates alone do not raise verification status. - Further research: Material needed: Actual acquisition and reading of external papers, registration, plans and support materials are needed. Historical-check wording, URLs and original material dates alone do not raise verification status. This records needed materials; no new research was executed. - Conditions for verification: Original material and analysis scope for Access status of originals, registration, protocols, analysis plans and support by report must be linked to the report's exacerbation, medication and care-management findings, between-arm comparisons, denominators and timing, distinguishing stored summaries, unverified details and primary versus secondary outcomes. - Why this condition is needed: This condition links Access status of originals, registration, protocols, analysis plans and support by report with populations, adjunctive training, comparators, medication policies, events, denominators, timing, analyses, precision, support and harms for the selected exacerbation-prevention or inhaled-therapy-replacement question. - Application exceptions: Retain original subclaim D and absent individual score, status and axes without inheriting parent C50 or positive-effect axes. Exacerbations, rescue use, maintenance ICS, asthma control, objective measures and complete therapy replacement are distinguished. Comparators, denominators, timing and prespecified hierarchy are not combined, and unread originals or registration and historical COI checks are not promoted into current verification. No new effects, CIs, independent totals, breathing, medication-change or treatment instructions are created. - Remaining uncertainty: External originals are unread and review of existing content remains incomplete. Original subclaim D, null exacerbations and supervised medication-reduction context are retained alongside gaps in events, arm-specific denominators, direct effects, CIs, complete replacement, prespecified plans, support and harms. Links, historical checks and design labels do not establish current reading or certification of independence, efficacy or safety. - Referenced methods: Preserved application conditions concerning questions, comparisons, reports versus trials, outcomes, denominators, errata and harms were referenced. - Related sources: S01, S02, S03, S04 ## Evidence and sources ### S01 Bowler SD, Green A, Mitchell CA. Buteyko breathing techniques in asthma: a blinded randomised controlled trial. Med J Aust. 1998;169:575-578. PMID: 9887897. DOI: 10.5694/j.1326-5377.1998.tb123422.x. [PubMed](https://pubmed.ncbi.nlm.nih.gov/9887897/) Materials actually read: Stored summary read; external materials unread Findings recorded in the summary: Median beta2-agonist reduction 904 versus 57 mcg, P=.002; FEV1 and PEF null; ICS P=.06 and QOL P=.09 Record level: This is the 3-month context in 39 adults with asthma in 1998. Median beta2-agonist reductions of 904 versus 57 mcg, P=.002, are distinguished from ICS P=.06, QOL P=.09 and null FEV1 and PEF. It is a related medication, symptom and objective-measure report, not direct confirmation of exacerbation prevention or complete replacement of inhaled therapy. Independent replication: The stored reports are shared with the parent and other subclaims. Report-specific linkage groups are not counted as established totals of unique trials, participants or independent replications. Agreement in symptom direction is not converted into independent confirmation of the same exacerbation or therapy-replacement question; exact registration, recruitment, cohort, support, comparator and endpoint links remain unverified. | 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 9887897, DOI 10.5694/j.1326-5377.1998.tb123422.x and preregistry-era wording. Specific funding, COI, support roles and independence are unverified. A blinding label and supervised-reduction context do not establish exacerbation prevention or inhaled-therapy replacement. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 9887897, DOI 10.5694/j.1326-5377.1998.tb123422.x and preregistry-era wording. Specific funding, COI, support roles and independence are unverified. A blinding label and supervised-reduction context do not establish exacerbation prevention or inhaled-therapy replacement. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 9887897, DOI 10.5694/j.1326-5377.1998.tb123422.x and preregistry-era wording. Specific funding, COI, support roles and independence are unverified. A blinding label and supervised-reduction context do not establish exacerbation prevention or inhaled-therapy replacement. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 9887897, DOI 10.5694/j.1326-5377.1998.tb123422.x and preregistry-era wording. Specific funding, COI, support roles and independence are unverified. A blinding label and supervised-reduction context do not establish exacerbation prevention or inhaled-therapy replacement. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 9887897, DOI 10.5694/j.1326-5377.1998.tb123422.x and preregistry-era wording. Specific funding, COI, support roles and independence are unverified. A blinding label and supervised-reduction context do not establish exacerbation prevention or inhaled-therapy replacement. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | 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 9887897, DOI 10.5694/j.1326-5377.1998.tb123422.x and preregistry-era wording. Specific funding, COI, support roles and independence are unverified. A blinding label and supervised-reduction context do not establish exacerbation prevention or inhaled-therapy replacement. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | ### S02 Cooper S, Oborne J, Newton S, et al. Effect of two breathing exercises (Buteyko and pranayama) in asthma: a randomised controlled trial. Thorax. 2003;58:674-679. PMID: 12885982. PMCID: PMC1746772. DOI: 10.1136/thorax.58.8.674. [PubMed](https://pubmed.ncbi.nlm.nih.gov/12885982/) Materials actually read: Stored summary read; external materials unread Findings recorded in the summary: Median symptom change -3 versus -1 versus 0, P=.003; bronchodilator -2 puffs/day, P=.005; objective outcomes, exacerbations, and ICS null Record level: The 2003 trial retains 3 arms and original wording of 90 assigned, 69 completed and 23% attrition. Null exacerbations and ICS are distinguished from symptoms of -3 versus -1 versus 0, P=.003, and bronchodilator -2 puffs/day, P=.005. It directly concerns the selected exacerbation outcome, but event counts, denominators, definitions, effects, CIs and prespecified hierarchy are unverified. Independent replication: The stored reports are shared with the parent and other subclaims. Report-specific linkage groups are not counted as established totals of unique trials, participants or independent replications. Agreement in symptom direction is not converted into independent confirmation of the same exacerbation or therapy-replacement question; exact registration, recruitment, cohort, support, comparator and endpoint links remain unverified. | 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 12885982, PMCID PMC1746772, DOI 10.1136/thorax.58.8.674 and preregistry-era wording. A PMCID does not establish full-text reading; completer, lack-of-masking and split co-primary contexts are retained. Funding, COI and direct exacerbation effects and CIs are unverified. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 12885982, PMCID PMC1746772, DOI 10.1136/thorax.58.8.674 and preregistry-era wording. A PMCID does not establish full-text reading; completer, lack-of-masking and split co-primary contexts are retained. Funding, COI and direct exacerbation effects and CIs are unverified. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 12885982, PMCID PMC1746772, DOI 10.1136/thorax.58.8.674 and preregistry-era wording. A PMCID does not establish full-text reading; completer, lack-of-masking and split co-primary contexts are retained. Funding, COI and direct exacerbation effects and CIs are unverified. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 12885982, PMCID PMC1746772, DOI 10.1136/thorax.58.8.674 and preregistry-era wording. A PMCID does not establish full-text reading; completer, lack-of-masking and split co-primary contexts are retained. Funding, COI and direct exacerbation effects and CIs are unverified. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 12885982, PMCID PMC1746772, DOI 10.1136/thorax.58.8.674 and preregistry-era wording. A PMCID does not establish full-text reading; completer, lack-of-masking and split co-primary contexts are retained. Funding, COI and direct exacerbation effects and CIs are unverified. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | 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 12885982, PMCID PMC1746772, DOI 10.1136/thorax.58.8.674 and preregistry-era wording. A PMCID does not establish full-text reading; completer, lack-of-masking and split co-primary contexts are retained. Funding, COI and direct exacerbation effects and CIs are unverified. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | ### S03 Cowie RL, Conley DP, Underwood MF, Reader PG. A randomised controlled trial of the Buteyko technique as an adjunct to conventional management of asthma. Respir Med. 2008;102:726-732. PMID: 18249107. DOI: 10.1016/j.rmed.2007.12.012. [PubMed](https://pubmed.ncbi.nlm.nih.gov/18249107/) Materials actually read: Stored summary read; external materials unread Findings recorded in the summary: Control 79% versus 72%, P=.4; missing-as-failure 68% versus 70%, P=.7; ICS reduction 23/56 versus 13/63, P=.02 Record level: The 2008 active-breathing-education comparison retains 129 assigned and 119 assessed at 6 months. Control of 79% versus 72%, P=.4, and missing-as-failure findings of 68% versus 70%, P=.7, are null; ICS reduction of 23/56 versus 13/63, P=.02, is a separate secondary outcome. These are not promoted into primary-outcome success, exacerbation prevention or complete replacement of inhaled therapy, and no new population difference is calculated. Independent replication: The stored reports are shared with the parent and other subclaims. Report-specific linkage groups are not counted as established totals of unique trials, participants or independent replications. Agreement in symptom direction is not converted into independent confirmation of the same exacerbation or therapy-replacement question; exact registration, recruitment, cohort, support, comparator and endpoint links remain unverified. | 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 18249107, DOI 10.1016/j.rmed.2007.12.012 and unverified registration. Anonymous donation, unverified independence and imbalanced withdrawals by arm are distinguished. Asthma-control and secondary ICS denominators do not establish exacerbation or complete-replacement denominators or confirmation. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 18249107, DOI 10.1016/j.rmed.2007.12.012 and unverified registration. Anonymous donation, unverified independence and imbalanced withdrawals by arm are distinguished. Asthma-control and secondary ICS denominators do not establish exacerbation or complete-replacement denominators or confirmation. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 18249107, DOI 10.1016/j.rmed.2007.12.012 and unverified registration. Anonymous donation, unverified independence and imbalanced withdrawals by arm are distinguished. Asthma-control and secondary ICS denominators do not establish exacerbation or complete-replacement denominators or confirmation. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 18249107, DOI 10.1016/j.rmed.2007.12.012 and unverified registration. Anonymous donation, unverified independence and imbalanced withdrawals by arm are distinguished. Asthma-control and secondary ICS denominators do not establish exacerbation or complete-replacement denominators or confirmation. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 18249107, DOI 10.1016/j.rmed.2007.12.012 and unverified registration. Anonymous donation, unverified independence and imbalanced withdrawals by arm are distinguished. Asthma-control and secondary ICS denominators do not establish exacerbation or complete-replacement denominators or confirmation. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | 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 18249107, DOI 10.1016/j.rmed.2007.12.012 and unverified registration. Anonymous donation, unverified independence and imbalanced withdrawals by arm are distinguished. Asthma-control and secondary ICS denominators do not establish exacerbation or complete-replacement denominators or confirmation. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | ### S04 Vagedes K, et al. Buteyko breathing technique for asthma: an effective intervention. Eur J Med Res. 2024;29:42. PMID: 38212823. PMCID: PMC10782792. DOI: 10.1186/s40001-023-01634-1. NCT03098849. [PubMed](https://pubmed.ncbi.nlm.nih.gov/38212823/) Materials actually read: Stored summary read; external materials unread Findings recorded in the summary: 1st and some 2nd outcome signals; FEV1 and FeNO null, registered after recruitment began Record level: This is the 2024 trial in 60 adults. The 1st outcome voluntary control pause and some 2nd-outcome ACQ and medication signals are distinguished from null FEV1 and FeNO. NCT03098849 registration after recruitment is original historical wording. Direct events and designs for selected exacerbation prevention or inhaled-therapy replacement are unverified; historical support or COI checks are not inherited as new reading. Independent replication: The stored reports are shared with the parent and other subclaims. Report-specific linkage groups are not counted as established totals of unique trials, participants or independent replications. Agreement in symptom direction is not converted into independent confirmation of the same exacerbation or therapy-replacement question; exact registration, recruitment, cohort, support, comparator and endpoint links remain unverified. | 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 38212823, PMCID PMC10782792, DOI 10.1186/s40001-023-01634-1 and NCT03098849. Original post-recruitment registration, public or institutional support and historical COI-check wording do not establish current registration or full-text reading or verified independence. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 38212823, PMCID PMC10782792, DOI 10.1186/s40001-023-01634-1 and NCT03098849. Original post-recruitment registration, public or institutional support and historical COI-check wording do not establish current registration or full-text reading or verified independence. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 38212823, PMCID PMC10782792, DOI 10.1186/s40001-023-01634-1 and NCT03098849. Original post-recruitment registration, public or institutional support and historical COI-check wording do not establish current registration or full-text reading or verified independence. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 38212823, PMCID PMC10782792, DOI 10.1186/s40001-023-01634-1 and NCT03098849. Original post-recruitment registration, public or institutional support and historical COI-check wording do not establish current registration or full-text reading or verified independence. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PMID 38212823, PMCID PMC10782792, DOI 10.1186/s40001-023-01634-1 and NCT03098849. Original post-recruitment registration, public or institutional support and historical COI-check wording do not establish current registration or full-text reading or verified independence. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | | 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 38212823, PMCID PMC10782792, DOI 10.1186/s40001-023-01634-1 and NCT03098849. Original post-recruitment registration, public or institutional support and historical COI-check wording do not establish current registration or full-text reading or verified independence. The material date belongs to the original evidence and is not a new external-reading or completed-content-review date. | ## 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 - Partly verified: Partial information from the stored summary is linked; detailed originals and content review remain incomplete. - Unverified: Required details cannot be established within the preserved scope. This does not establish absence of effects or studies, or safety. - Review incomplete: Review of existing content remains incomplete. - Met: This state is used only within the relevant conditions after material verification and content review. It was not automatically assigned in this work. - Not reported: Unreported within material actually read. Unread external material is not relabeled as unreported. - Inaccessible: This means actual access failure. External access was not attempted in this work, so this state was not assigned. - Not applicable: Used only with an application exception and reason based on the question scope. - Conflicting data: This requires actual comparison of materials; no new conflict judgment was made in this work. - Insufficient evidence for the conditions: This indicates gaps in additional material for the selected conditions. Unread material as a whole is not converted into an efficacy grade. ## Change history 2026-10-19 · Public page/materials 1.0. Public-facing views and materials were prepared from the existing 28 items. No new clinical search, verification-status change or scoring was performed.