# Medical-grade manuka honey × MGD dry-eye symptoms: added benefit over existing care unverified Verdict 3016 · 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: 2026-10-21 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: Evaporative dry eye from meibomian gland dysfunction. Detailed diagnosis, severity, baseline status, eligibility and group composition remain unverified. - Ingredient, formulation and route: Medical-grade 16% manuka-honey drops or 98% gel were added to existing lid care. Formulations are distinguished from each other and from food-grade or nonsterile products. - Dose: 16% and 98% are concentrations of different formulations. Actual instilled amount, frequency, adherence and exposure remain unverified; concentration is not converted into administered dose. - Comparator: Common warm compresses, lid massage and preservative-free lubricant in the 2017 trial are distinguished from comparison with regular lubricant in the 2021 trial. Details of matched group care and changes remain unverified. - Measured outcome: 3-week SPEED symptoms are distinguished from selected staining and meibomian signs. Different within-group P values do not replace direct between-group symptom effects. - Duration: The principal direct trial over 8 weeks is distinguished from the supporting symptom trial over 3 weeks. Long-term and post-stopping effects and harms remain unverified. - Questions outside this scope: Selected C and absent individual score are distinguished from parent C46, selected-signs C and food-honey self-instillation F. Parent score or axes are not newly filled into the subquestion.; 16% drops and 98% gel are not combined, and medical-grade sterile products are not expanded into evidence for food-grade, nonsterile or homemade-dilution instillation.; SPEED 2.53 points P=.006 and 1.087 points P=.183 are original within-group records. New differences, between-group superiority or CIs are not calculated.; Selected staining P=.035, meibum quality P=.005 and gland expressibility P=.042 signals are not converted into patient symptom effects.; 114 participants and 59 randomized with 55 completed are distinguished without calculating new attrition counts, group, eye, patient or safety denominators, or incidence.; Shared reports are not counted as new independent replication for each question. Short-term symptoms and signs are not expanded into long-term recovery, treatment replacement or overall safety. ## Checklist items ### N01 · Which symptom question does this evidence check cover? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The existing subquestion is improved dry-eye symptoms over existing care. The original explanation that different within-group P values do not establish direct superiority is retained. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Whether dry-eye symptoms improve more than with existing care and the scope of added benefit - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N02 · What is the hierarchy of SPEED and other symptom scales? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The supporting trial lists 3-week SPEED, tear film, inflammation and staining as outcomes. The principal trial covered multiple symptoms and signs. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: SPEED is not duplicated across all symptoms and signs; scales, time points, prespecified plans, all symptom tables and denominators remain unverified. - Required materials and conditions: The main symptom scale, version, time point, baseline and between-group results - Materials to obtain first: SPEED is not duplicated across all symptoms and signs; scales, time points, prespecified plans, all symptom tables and denominators remain unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N03 · What was the SPEED change in the honey-drop group? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The supporting trial reported a within-group SPEED change of 2.53 points, P=.006, in the honey group. This is a before-and-after record in that group. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: The honey group's 3-week SPEED change, original analysis and denominator - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N04 · How is the regular-lubricant group's change distinguished? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The original control within-group change was 1.087 points, P=.183. Nonsignificance in control is not a test of honey-group superiority. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: The regular-lubricant group's 3-week SPEED change and comparison conditions - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N05 · Are P=.006 and P=.183 a between-group superiority test? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The original account explicitly states that the different within-group P values are not a superiority test. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Direct comparison of the changes, between-group P values and CIs - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N06 · Are the direct between-group symptom effect and 95% CI verified? Verification status: Unverified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The stored summary records that the supporting trial's abstract did not present a direct between-group symptom effect. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: The added symptom effect and its original uncertainty - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N07 · Can overall improvement in 114 participants and 3 groups be assigned to the product? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: All groups in the principal trial improved and used common warm compresses, lid massage and preservative-free lubricant. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Added symptom benefit over common care and group-specific results - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N08 · Are 16% drops and 98% gel the same formulation? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The original record distinguishes 16% drops and 98% gel as different formulations. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Formulation-specific symptom effects, administered amounts, frequency and control - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N09 · Are selected P values for clinical signs symptom effects? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: In the principal trial, staining with drops P=.035 and gel meibum quality P=.005 and gland expressibility P=.042 were signals in selected signs. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: The direct relevance of staining and meibomian measures to symptom outcomes - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N10 · Does assessor masking also mean participant masking? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The supporting trial's original design was an assessor-masked randomized trial. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: The roles of assessor masking and symptom reporting and measurement - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N11 · What are the limitations of open treatment and multiple outcomes? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The principal trial used an open 3-group randomized design and retained multiple symptoms and signs. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: The principal trial's open 3-group methods, prespecified symptom outcomes and all results - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N12 · Are 3 weeks and the principal 8 weeks the same duration? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The principal direct trial's 8 weeks and the supporting trial's 3-week SPEED measure are distinguished in the original account. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: The supporting trial's 3 weeks, the principal trial's 8 weeks, and long-term and post-stopping results - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N13 · Are symptom importance, responders and lubricant use verified? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The original outcome list includes symptoms and lubricant use, but prespecified importance, responders and exact between-group medication use are not detailed. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: Thresholds, responders, medication use, denominators, CIs and prespecified hierarchy remain unverified. Within-group means are not converted into treatment-success rates or medication replacement. - Required materials and conditions: Direct material on SPEED importance, responders, lubricant and rescue-medication use - Materials to obtain first: Thresholds, responders, medication use, denominators, CIs and prespecified hierarchy remain unverified. Within-group means are not converted into treatment-success rates or medication replacement. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N14 · How are medical-grade sterile products distinguished from food honey? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The original record concerns ophthalmic medical-grade products, not evidence for food-grade manuka honey or homemade dilution. Concentration differs from actual instilled amount and frequency. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Manufacture, quality and actual administration of medical-grade 16% drops and 98% gel - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N15 · What was added to common lid care? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: In 2017, all groups used common warm compresses, lid massage and preservative-free lubricant. The comparison added medical-grade honey products to that care. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Warm compresses, massage, preservative-free lubricant and formulation-specific additional care - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N16 · Are MGD diagnosis and sample size the same information? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The parent question concerns evaporative dry eye from meibomian gland dysfunction. 114 participants is the original sample-size label. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Diagnosis, severity, baseline status and group-specific eligibility in evaporative dry eye - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N17 · What are the symptom denominators in 114 participants and 3 groups? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The principal trial's sample was 114 participants and its design was an open 3-group randomized trial. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Group allocation, completion, analysis and endpoint-specific eye and patient denominators - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N18 · What denominators are 59 randomized and 55 completed? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The supporting trial originally recorded 59 randomized and 55 completed. These values describe separate stages. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Supporting-trial allocation, completion, analysis and group, eye and patient endpoint denominators - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N19 · What is the impact of missingness, attrition and measurement exclusions? Verification status: Unverified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: Overall sample and completion records exist, but endpoint-specific missingness, attrition reasons and analysis conditions are not detailed. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Group flow, missing symptom outcomes, analysis populations and sensitivity analyses - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N20 · What were the baseline adjustment, change and testing conditions? Verification status: Unverified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: Original P values and selected changes are retained, but detailed adjustment, variance, time points, denominators and effects of interest remain unread in external originals. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: The effect of interest, baseline adjustment, change and final values, and variance - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N21 · Does a registration number also verify prespecified plans? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: Registration was unverified for the principal trial, while NCT04457648 was recorded for the supporting trial. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Registration, history, primary outcomes, changes and original plans for both trials - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N22 · Do parent and subquestions share the same reports? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The parent and subquestions share the same Albietz 2017 and Wong 2021 reports. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Report, trial and participant links between the symptom question and other questions - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N23 · Is independent replication across teams, products and formulations verified? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The bibliographies of both reports retain an Albietz author and the specific Optimel product context. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Unique trials and independent teams for the same symptoms, formulation, population, comparison and time point - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N24 · How much is known about product provision and company involvement? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The principal trial records Optimel product provision and related involvement; the supporting trial records a specific Optimel product, provision and author conflict disclosure. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Trial-specific funding, product support, employee authors and conflicts - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N25 · What is the scope of reported stinging and redness? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The original record reports temporary stinging and redness and cautions that initial symptoms are possible even with medical-grade formulations. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: Event counts, incidence or new causality are not created. Collection methods, group and formulation-specific events, severity, timing, stopping, missingness and controls remain unverified. - Required materials and conditions: Medical-grade product adverse reactions, collection methods, stopping and controls - Materials to obtain first: Event counts, incidence or new causality are not created. Collection methods, group and formulation-specific events, severity, timing, stopping, missingness and controls remain unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N26 · What are the eye and patient harm denominators and exposures? Verification status: Unverified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: 114 participants, 59 randomized and 55 completed do not verify safety denominators. Concentrations, formulations, 3 and 8 weeks and common care are not combined as the same harm exposure. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: Safety denominators, actual instillation, group, eye and formulation-specific events, stopping, exposure and controls remain unverified. Incidence is not calculated. - Required materials and conditions: Safety populations, eyes, patients, formulations, durations and actual instillation exposure - Materials to obtain first: Safety denominators, actual instillation, group, eye and formulation-specific events, stopping, exposure and controls remain unverified. Incidence is not calculated. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N27 · Are food or nonsterile risks distinguished from medical-grade product reactions? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The original caution distinguishes infection and corneal-injury risks with food-grade, nonsterile and homemade dilutions from initial stinging and redness with medical-grade products. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Manufacture, sterility, baseline eye conditions, other causes and clinical course - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N28 · Are long-term, rare and vulnerable-population harms verified? Verification status: Unverified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: Small short-term trials of specific products and descriptions of temporary reactions do not verify long-term, rare or vulnerable-population safety. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: Long exposure, independent harm reports, vulnerable populations and follow-up - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N29 · How does stored-summary reading differ from reading external originals? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The complete parent Korean and English summary, reports and citations were read. PubMed URLs and registration numbers are existing records; external abstracts, full texts, registration, protocols and analysis plans were unread in this work. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: The complete stored summary and the reading scope for external abstracts, full texts, registration and plans - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ### N30 · What do selected C, parent C46, dates and empty values record? Verification status: Partly verified Reading scope: Complete stored parent Korean and English summary, selected question and bibliography read; external abstracts, full text, registration, protocols and analysis plans unread - Current findings: The selected grade is C, with no individual score, status or axes fields. Parent C46, caution, axes, Korean and English records, 2026-09-07 and empty correction and deliberation records are preserved separately. - Why unverified: This state links partial information and gaps in the preserved selected and parent accounts. External verification and clinical content review remain incomplete; it does not certify fulfilled conditions, efficacy, safety, prespecification or independence. - Reason for missing information: 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. - Required materials and conditions: The selected grade, absent individual score, parent axes, evidence date and corrections - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: Direct between-group symptom effects, CIs, importance, group and eye denominators, baseline adjustment, missingness, prespecified plans, actual exposure, involvement and independence, long-term effects and harms remain unverified. Original numbers and historical verification wording are not promoted into new calculations, current external reading or completed clinical review. - Referenced methods: Preserved principles distinguishing questions, direct comparisons, reports and trials, endpoints, denominators, precision and harms informed production. - Related sources: R01, R02 ## Evidence and sources ### R01 Albietz JM·Lenton LM. 2017 [PubMed](https://pubmed.ncbi.nlm.nih.gov/28585260/) Materials actually read: The complete stored parent Korean and English summary, original reports and citations were read. External abstracts, full texts, registration, protocols and analysis plans were unread in this work. Findings recorded in the summary: The original comparison in 114 participants added 16% drops or 98% gel to common care. All groups improved; selected sign signals included staining with drops P=.035 and gel meibum quality P=.005 and gland expressibility P=.042. Record level: Selected formulation-specific signs are not converted into direct symptom superiority. The original principal duration is 8 weeks; group-specific symptom effects, precision, eye and patient denominators and prespecified hierarchy remain unverified. Independent replication: Parent 3016 and the symptom and selected-sign questions share 2 reports, Albietz 2017 and Wong 2021. Shared authors and the specific Optimel product context are retained, while exact sample overlap, unique trial and participant totals and independent replication 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 | PMID28585260, DOI10.1111/cxo.12524 and the original record of Optimel product provision and related involvement are retained. Registration details, product contracts, funding and author roles are unread externally; unverified information is not converted into absence. The stored-summary material date 2026-10-06T13:02:14.255886+09:00 is an original production record; unread external material dates are empty. The historical evidence date 2026-09-07 is distinguished from this publication, external reading or completed clinical review. | | External abstract | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | PMID28585260, DOI10.1111/cxo.12524 and the original record of Optimel product provision and related involvement are retained. Registration details, product contracts, funding and author roles are unread externally; unverified information is not converted into absence. The stored-summary material date 2026-10-06T13:02:14.255886+09:00 is an original production record; unread external material dates are empty. The historical evidence date 2026-09-07 is distinguished from this publication, external reading or completed clinical review. | | External full text | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | PMID28585260, DOI10.1111/cxo.12524 and the original record of Optimel product provision and related involvement are retained. Registration details, product contracts, funding and author roles are unread externally; unverified information is not converted into absence. The stored-summary material date 2026-10-06T13:02:14.255886+09:00 is an original production record; unread external material dates are empty. The historical evidence date 2026-09-07 is distinguished from this publication, external reading or completed clinical review. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | PMID28585260, DOI10.1111/cxo.12524 and the original record of Optimel product provision and related involvement are retained. Registration details, product contracts, funding and author roles are unread externally; unverified information is not converted into absence. The stored-summary material date 2026-10-06T13:02:14.255886+09:00 is an original production record; unread external material dates are empty. The historical evidence date 2026-09-07 is distinguished from this publication, external reading or completed clinical review. | | Protocol and analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | PMID28585260, DOI10.1111/cxo.12524 and the original record of Optimel product provision and related involvement are retained. Registration details, product contracts, funding and author roles are unread externally; unverified information is not converted into absence. The stored-summary material date 2026-10-06T13:02:14.255886+09:00 is an original production record; unread external material dates are empty. The historical evidence date 2026-09-07 is distinguished from this publication, external reading or completed clinical review. | ### R02 Wong D et al. 2021 [PubMed](https://pubmed.ncbi.nlm.nih.gov/33419788/) Materials actually read: The complete stored parent Korean and English summary, original reports and citations were read. External abstracts, full texts, registration, protocols and analysis plans were unread in this work. Findings recorded in the summary: 59 randomized and 55 completed were recorded, with 3-week within-group SPEED changes of 2.53 points P=.006 for honey drops and 1.087 points P=.183 for regular lubricant. The stored summary states that the abstract did not present a direct between-group symptom effect. Record level: Different within-group P values are not a superiority test. Assessor masking is not promoted into participant or treatment-provider masking. New differences in changes, CIs, attrition counts or safety denominators are not calculated. Independent replication: Parent 3016 and the symptom and selected-sign questions share 2 reports, Albietz 2017 and Wong 2021. Shared authors and the specific Optimel product context are retained, while exact sample overlap, unique trial and participant totals and independent replication 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 | PMID33419788, DOI10.1136/bjophthalmol-2020-317506, NCT04457648, specific Optimel product provision and author conflict disclosure are retained. The number does not establish registration reading in this work, prespecification or plan adherence; disclosure details are unread. The stored-summary material date 2026-10-06T13:02:14.255886+09:00 is an original production record; unread external material dates are empty. The historical evidence date 2026-09-07 is distinguished from this publication, external reading or completed clinical review. | | External abstract | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | PMID33419788, DOI10.1136/bjophthalmol-2020-317506, NCT04457648, specific Optimel product provision and author conflict disclosure are retained. The number does not establish registration reading in this work, prespecification or plan adherence; disclosure details are unread. The stored-summary material date 2026-10-06T13:02:14.255886+09:00 is an original production record; unread external material dates are empty. The historical evidence date 2026-09-07 is distinguished from this publication, external reading or completed clinical review. | | External full text | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | PMID33419788, DOI10.1136/bjophthalmol-2020-317506, NCT04457648, specific Optimel product provision and author conflict disclosure are retained. The number does not establish registration reading in this work, prespecification or plan adherence; disclosure details are unread. The stored-summary material date 2026-10-06T13:02:14.255886+09:00 is an original production record; unread external material dates are empty. The historical evidence date 2026-09-07 is distinguished from this publication, external reading or completed clinical review. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | PMID33419788, DOI10.1136/bjophthalmol-2020-317506, NCT04457648, specific Optimel product provision and author conflict disclosure are retained. The number does not establish registration reading in this work, prespecification or plan adherence; disclosure details are unread. The stored-summary material date 2026-10-06T13:02:14.255886+09:00 is an original production record; unread external material dates are empty. The historical evidence date 2026-09-07 is distinguished from this publication, external reading or completed clinical review. | | Protocol and analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | PMID33419788, DOI10.1136/bjophthalmol-2020-317506, NCT04457648, specific Optimel product provision and author conflict disclosure are retained. The number does not establish registration reading in this work, prespecification or plan adherence; disclosure details are unread. The stored-summary material date 2026-10-06T13:02:14.255886+09:00 is an original production record; unread external material dates are empty. The historical evidence date 2026-09-07 is distinguished from this publication, external reading or completed clinical review. | ## 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 2026-10-21 · Public page/materials 1.0. Public-facing views and materials were prepared from the existing 30 items. No new clinical search, verification-status change or scoring was performed.