{
  "schema_version": "chamgap-public-criteria-1.0",
  "title": "Medical-grade manuka honey × MGD dry-eye symptoms: added benefit over existing care unverified",
  "language": "en",
  "translation_date": "2026-10-21",
  "criteria_version": "1.0",
  "criteria_date": "2026-10-06",
  "condition_origin": "Chamgap's own application conditions",
  "method_sources": [
    {
      "id": "M03",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03",
      "section": "§3.1, §3.2.1–3.2.3, MECIR C5/C7/C13",
      "official_principle": "Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.",
      "review_level": "Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed."
    },
    {
      "id": "M04",
      "version": "Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04",
      "section": "§4.5, §4.6.1–4.6.3, MECIR C42",
      "official_principle": "Distinguish studies from reports and link them; do not omit a study solely because results are unreported.",
      "review_level": "Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed."
    },
    {
      "id": "M08",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08",
      "section": "§8.1–8.2.3, Table 8.2.a",
      "official_principle": "Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.",
      "review_level": "Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed."
    },
    {
      "id": "M15",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15",
      "section": "§15.2.4, §15.3.1–15.3.3",
      "official_principle": "Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.",
      "review_level": "Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed."
    },
    {
      "id": "M19",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19",
      "section": "§19.1.2, §19.2.1–19.2.4",
      "official_principle": "Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.",
      "review_level": "Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed."
    }
  ],
  "status_dictionary": {
    "Partly verified": "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."
  },
  "requirements": [
    {
      "item_id": "N01",
      "question_type": "Evidence condition",
      "question": "Which symptom question does this evidence check cover?",
      "needed": "Whether dry-eye symptoms improve more than with existing care and the scope of added benefit",
      "role": "Required",
      "role_reason": "Material on Whether dry-eye symptoms improve more than with existing care and the scope of added benefit is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Whether dry-eye symptoms improve more than with existing care and the scope of added benefit must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: The parent verdict's symptoms and signs are not combined into a single symptom effect; original direct symptom outcomes, controls, denominators and between-group estimates are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N02",
      "question_type": "Evidence condition",
      "question": "What is the hierarchy of SPEED and other symptom scales?",
      "needed": "The main symptom scale, version, time point, baseline and between-group results",
      "role": "Required",
      "role_reason": "Material on The main symptom scale, version, time point, baseline and between-group results is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The main symptom scale, version, time point, baseline and between-group results must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: SPEED is not duplicated across all symptoms and signs; scales, time points, prespecified plans, all symptom tables and denominators remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N03",
      "question_type": "Evidence condition",
      "question": "What was the SPEED change in the honey-drop group?",
      "needed": "The honey group's 3-week SPEED change, original analysis and denominator",
      "role": "Required",
      "role_reason": "Material on The honey group's 3-week SPEED change, original analysis and denominator is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The honey group's 3-week SPEED change, original analysis and denominator must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: It is not converted into added benefit over existing care; baseline and final values, models, variance, denominators and direct between-group results remain unverified. No new difference or CI is calculated. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N04",
      "question_type": "Evidence condition",
      "question": "How is the regular-lubricant group's change distinguished?",
      "needed": "The regular-lubricant group's 3-week SPEED change and comparison conditions",
      "role": "Required",
      "role_reason": "Material on The regular-lubricant group's 3-week SPEED change and comparison conditions is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The regular-lubricant group's 3-week SPEED change and comparison conditions must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Control ingredients, within-group tables, denominators, dispersion and between-group contrasts remain unverified. 1.087 is not subtracted from 2.53 to create a new added effect. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N05",
      "question_type": "Evidence condition",
      "question": "Are P=.006 and P=.183 a between-group superiority test?",
      "needed": "Direct comparison of the changes, between-group P values and CIs",
      "role": "Required",
      "role_reason": "Material on Direct comparison of the changes, between-group P values and CIs is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Direct comparison of the changes, between-group P values and CIs must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: A difference in P values is not treated as a significant difference in effects; direct between-group estimates, CIs, denominators, models, multiplicity and prespecified plans remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N06",
      "question_type": "Evidence condition",
      "question": "Are the direct between-group symptom effect and 95% CI verified?",
      "needed": "The added symptom effect and its original uncertainty",
      "role": "Required",
      "role_reason": "Material on The added symptom effect and its original uncertainty is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The added symptom effect and its original uncertainty must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: That record about the original abstract is distinguished from external materials being unread in this work. Exact between-group results, CIs, P values, denominators, adjustment and variance remain unverified, without conversion into no effect or established efficacy. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N07",
      "question_type": "Evidence condition",
      "question": "Can overall improvement in 114 participants and 3 groups be assigned to the product?",
      "needed": "Added symptom benefit over common care and group-specific results",
      "role": "Required",
      "role_reason": "Material on Added symptom benefit over common care and group-specific results is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Added symptom benefit over common care and group-specific results must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Overall improvement is not assigned to honey as an ingredient; group-specific symptoms, baselines, time points, denominators, common-care adherence and direct between-group contrasts remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N08",
      "question_type": "Evidence condition",
      "question": "Are 16% drops and 98% gel the same formulation?",
      "needed": "Formulation-specific symptom effects, administered amounts, frequency and control",
      "role": "Required",
      "role_reason": "Material on Formulation-specific symptom effects, administered amounts, frequency and control is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Formulation-specific symptom effects, administered amounts, frequency and control must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: An effect from one formulation is not copied to or pooled with another. Formulation-specific products, administered amounts, frequency, symptom scales, denominators, time points and between-group effects remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N09",
      "question_type": "Evidence condition",
      "question": "Are selected P values for clinical signs symptom effects?",
      "needed": "The direct relevance of staining and meibomian measures to symptom outcomes",
      "role": "Supplementary",
      "role_reason": "Material on The direct relevance of staining and meibomian measures to symptom outcomes is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The direct relevance of staining and meibomian measures to symptom outcomes must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: These values are not converted into SPEED or patient symptom-effect estimates. Original sign and symptom tables, hierarchy, denominators, formulation and time-point matching remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N10",
      "question_type": "Evidence condition",
      "question": "Does assessor masking also mean participant masking?",
      "needed": "The roles of assessor masking and symptom reporting and measurement",
      "role": "Required",
      "role_reason": "Material on The roles of assessor masking and symptom reporting and measurement is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The roles of assessor masking and symptom reporting and measurement must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Double masking of participants and treatment providers or exclusion of expectancy effects is not newly verified. Allocation, concealment, masking roles, symptom responses, control appearance, stinging and assessment methods remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N11",
      "question_type": "Evidence condition",
      "question": "What are the limitations of open treatment and multiple outcomes?",
      "needed": "The principal trial's open 3-group methods, prespecified symptom outcomes and all results",
      "role": "Required",
      "role_reason": "Material on The principal trial's open 3-group methods, prespecified symptom outcomes and all results is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The principal trial's open 3-group methods, prespecified symptom outcomes and all results must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Selected findings are not expanded into superiority for all symptoms. Original methods, registration, protocols, analysis plans, all time points and multiplicity plans remain unverified; no new official assessment is created. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N12",
      "question_type": "Evidence condition",
      "question": "Are 3 weeks and the principal 8 weeks the same duration?",
      "needed": "The supporting trial's 3 weeks, the principal trial's 8 weeks, and long-term and post-stopping results",
      "role": "Required",
      "role_reason": "Material on The supporting trial's 3 weeks, the principal trial's 8 weeks, and long-term and post-stopping results is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The supporting trial's 3 weeks, the principal trial's 8 weeks, and long-term and post-stopping results must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: One trial's time point is not assigned to another trial or to long-term durability. Report-specific schedules, administration, adherence, endpoint denominators and long-term and post-stopping material remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N13",
      "question_type": "Evidence condition",
      "question": "Are symptom importance, responders and lubricant use verified?",
      "needed": "Direct material on SPEED importance, responders, lubricant and rescue-medication use",
      "role": "Supplementary",
      "role_reason": "Material on Direct material on SPEED importance, responders, lubricant and rescue-medication use is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Direct material on SPEED importance, responders, lubricant and rescue-medication use must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Thresholds, responders, medication use, denominators, CIs and prespecified hierarchy remain unverified. Within-group means are not converted into treatment-success rates or medication replacement. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N14",
      "question_type": "Evidence condition",
      "question": "How are medical-grade sterile products distinguished from food honey?",
      "needed": "Manufacture, quality and actual administration of medical-grade 16% drops and 98% gel",
      "role": "Required",
      "role_reason": "Material on Manufacture, quality and actual administration of medical-grade 16% drops and 98% gel is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Manufacture, quality and actual administration of medical-grade 16% drops and 98% gel must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Product, sterility, ingredients, manufacture, dose, frequency and administration records remain unverified in detail. Medical-grade product records are not expanded into effects of food-grade or nonsterile products. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N15",
      "question_type": "Evidence condition",
      "question": "What was added to common lid care?",
      "needed": "Warm compresses, massage, preservative-free lubricant and formulation-specific additional care",
      "role": "Required",
      "role_reason": "Material on Warm compresses, massage, preservative-free lubricant and formulation-specific additional care is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Warm compresses, massage, preservative-free lubricant and formulation-specific additional care must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: It is not converted into evidence for stopping care or standalone treatment. Common-care rules, adherence, additional and rescue medications, formulation-specific matching and changes remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N16",
      "question_type": "Evidence condition",
      "question": "Are MGD diagnosis and sample size the same information?",
      "needed": "Diagnosis, severity, baseline status and group-specific eligibility in evaporative dry eye",
      "role": "Required",
      "role_reason": "Material on Diagnosis, severity, baseline status and group-specific eligibility in evaporative dry eye is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Diagnosis, severity, baseline status and group-specific eligibility in evaporative dry eye must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Sample size does not replace diagnostic or eligibility criteria. Diagnosis, severity, baseline symptoms and signs, age, comorbidities and group-specific inclusion and exclusion remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N17",
      "question_type": "Evidence condition",
      "question": "What are the symptom denominators in 114 participants and 3 groups?",
      "needed": "Group allocation, completion, analysis and endpoint-specific eye and patient denominators",
      "role": "Required",
      "role_reason": "Material on Group allocation, completion, analysis and endpoint-specific eye and patient denominators is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Group allocation, completion, analysis and endpoint-specific eye and patient denominators must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Group allocation, completion, formulations, care groups, endpoints, time points, bilateral-eye and patient denominators and exclusions remain unverified. Denominators absent from the original are not created. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N18",
      "question_type": "Evidence condition",
      "question": "What denominators are 59 randomized and 55 completed?",
      "needed": "Supporting-trial allocation, completion, analysis and group, eye and patient endpoint denominators",
      "role": "Required",
      "role_reason": "Material on Supporting-trial allocation, completion, analysis and group, eye and patient endpoint denominators is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Supporting-trial allocation, completion, analysis and group, eye and patient endpoint denominators must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Attrition counts or group-specific and endpoint-specific analysis denominators are not calculated or established. Group flow, reasons, time points and eye and patient denominators remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N19",
      "question_type": "Evidence condition",
      "question": "What is the impact of missingness, attrition and measurement exclusions?",
      "needed": "Group flow, missing symptom outcomes, analysis populations and sensitivity analyses",
      "role": "Required",
      "role_reason": "Material on Group flow, missing symptom outcomes, analysis populations and sensitivity analyses is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Group flow, missing symptom outcomes, analysis populations and sensitivity analyses must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Unread external material is not converted into absence of missingness. Missingness, stopping, exclusions, ITT and completer analyses, missing-data handling, sensitivity and group and eye matching remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N20",
      "question_type": "Evidence condition",
      "question": "What were the baseline adjustment, change and testing conditions?",
      "needed": "The effect of interest, baseline adjustment, change and final values, and variance",
      "role": "Required",
      "role_reason": "Material on The effect of interest, baseline adjustment, change and final values, and variance is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The effect of interest, baseline adjustment, change and final values, and variance must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Original analysis plans, statistical tables, baseline and changes, within-eye and within-person correlation, models and CIs remain unverified. New effects or CIs are not back-calculated. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N21",
      "question_type": "Evidence condition",
      "question": "Does a registration number also verify prespecified plans?",
      "needed": "Registration, history, primary outcomes, changes and original plans for both trials",
      "role": "Required",
      "role_reason": "Material on Registration, history, primary outcomes, changes and original plans for both trials is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Registration, history, primary outcomes, changes and original plans for both trials must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: The number's existence is not promoted into registration reading in this work, prespecification, hierarchy at all time points or plan adherence. Official registration history, protocols and analysis plans were unread in this work. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N22",
      "question_type": "Evidence condition",
      "question": "Do parent and subquestions share the same reports?",
      "needed": "Report, trial and participant links between the symptom question and other questions",
      "role": "Required",
      "role_reason": "Material on Report, trial and participant links between the symptom question and other questions is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Report, trial and participant links between the symptom question and other questions must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Sheet counts are not counted as new studies or independent replications. Report, trial, registration, sample, institution, timing and additional-report matching and unique trial and participant totals remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N23",
      "question_type": "Evidence condition",
      "question": "Is independent replication across teams, products and formulations verified?",
      "needed": "Unique trials and independent teams for the same symptoms, formulation, population, comparison and time point",
      "role": "Supplementary",
      "role_reason": "Material on Unique trials and independent teams for the same symptoms, formulation, population, comparison and time point is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Unique trials and independent teams for the same symptoms, formulation, population, comparison and time point must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Different reports or assessor masking alone do not newly establish independent teams or replication under the same conditions. Team, institution, product, funding, participant, effect and denominator matching remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N24",
      "question_type": "Evidence condition",
      "question": "How much is known about product provision and company involvement?",
      "needed": "Trial-specific funding, product support, employee authors and conflicts",
      "role": "Required",
      "role_reason": "Material on Trial-specific funding, product support, employee authors and conflicts is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Trial-specific funding, product support, employee authors and conflicts must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Unrecorded funding, employee relationships, analysis and publication roles remain unverified. Product provision is not treated as verification of every involvement route or as absence of independence. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N25",
      "question_type": "Evidence condition",
      "question": "What is the scope of reported stinging and redness?",
      "needed": "Medical-grade product adverse reactions, collection methods, stopping and controls",
      "role": "Supplementary",
      "role_reason": "Material on Medical-grade product adverse reactions, collection methods, stopping and controls is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Medical-grade product adverse reactions, collection methods, stopping and controls must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Event counts, incidence or new causality are not created. Collection methods, group and formulation-specific events, severity, timing, stopping, missingness and controls remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N26",
      "question_type": "Evidence condition",
      "question": "What are the eye and patient harm denominators and exposures?",
      "needed": "Safety populations, eyes, patients, formulations, durations and actual instillation exposure",
      "role": "Supplementary",
      "role_reason": "Material on Safety populations, eyes, patients, formulations, durations and actual instillation exposure is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Safety populations, eyes, patients, formulations, durations and actual instillation exposure must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Safety denominators, actual instillation, group, eye and formulation-specific events, stopping, exposure and controls remain unverified. Incidence is not calculated. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N27",
      "question_type": "Evidence condition",
      "question": "Are food or nonsterile risks distinguished from medical-grade product reactions?",
      "needed": "Manufacture, sterility, baseline eye conditions, other causes and clinical course",
      "role": "Supplementary",
      "role_reason": "Material on Manufacture, sterility, baseline eye conditions, other causes and clinical course is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Manufacture, sterility, baseline eye conditions, other causes and clinical course must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: The food-honey self-instillation question is distinguished and no new case is created. Products, baseline eye conditions, concurrent use, event timing, alternative causes, controls and course remain unverified; no new harm causality is judged. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N28",
      "question_type": "Evidence condition",
      "question": "Are long-term, rare and vulnerable-population harms verified?",
      "needed": "Long exposure, independent harm reports, vulnerable populations and follow-up",
      "role": "Supplementary",
      "role_reason": "Material on Long exposure, independent harm reports, vulnerable populations and follow-up is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on Long exposure, independent harm reports, vulnerable populations and follow-up must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: Long follow-up, independent harm reports, vulnerable populations, exposure, denominators, concurrent use and course remain unverified. No external search or new harm judgment was performed in this work. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N29",
      "question_type": "Evidence condition",
      "question": "How does stored-summary reading differ from reading external originals?",
      "needed": "The complete stored summary and the reading scope for external abstracts, full texts, registration and plans",
      "role": "Required",
      "role_reason": "Material on The complete stored summary and the reading scope for external abstracts, full texts, registration and plans is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The complete stored summary and the reading scope for external abstracts, full texts, registration and plans must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: URLs, numbers and historical verification wording do not establish current reading, successful access or fulfilled conditions. External detailed-material availability, acquisition and actual reading remain separately unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N30",
      "question_type": "Evidence condition",
      "question": "What do selected C, parent C46, dates and empty values record?",
      "needed": "The selected grade, absent individual score, parent axes, evidence date and corrections",
      "role": "Required",
      "role_reason": "Material on The selected grade, absent individual score, parent axes, evidence date and corrections is needed to connect the medical-grade product, formulation, existing care, population, comparison, symptoms and signs, time point, denominators, precision and harms.",
      "application_exception": "Selected C and absent individual score, status and axes are retained, distinguishing parent C46, selected-signs C and food-honey self-instillation F. Within-group P values and signs are not converted into direct between-group symptom effects, and formulations, eyes and patients, and safety denominators are not combined. No new effects, CIs, differences, attrition counts, incidence, unique totals, grades or individual-care guidance are created.",
      "criterion": "Original material on The selected grade, absent individual score, parent axes, evidence date and corrections must link to the same question, control, endpoint, time point and denominators, distinguishing within- and between-group results, parent context and unread external materials.",
      "basis": "Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production.",
      "condition_origin": "These are evidence conditions for the existing subquestion of improved dry-eye symptoms over existing care. They do not establish preregistration, execution of an official assessment tool or completed clinical content review.",
      "proposed_research": "Material needed: The parent's 46 points are not assigned as a subclaim score, and the historical evidence date is not changed into a new search, external reading or completed-review date. New material, condition revisions and verdict changes are separate events. This records needed materials; no new research was executed."
    }
  ]
}