# Aphios purified liquid ginger-extract capsules as add-on therapy × Reduction of acute nausea severity in the first 24 hours after chemotherapy

Verdict 3048 · Evidence Check

Stored-material review date: 2026-10-06T09:33:39.802275+09:00  
Original evidence cut-off: 2026-09-08  
Review-criteria version: 1.0  
Public page/material preparation date: 2026-10-25

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: Adults with prior chemotherapy nausea; the question retains 5-HT3 antagonists plus corticosteroids.
- Ingredient, formulation and route: Oral add-on Aphios purified liquid ginger extract in olive-oil carrier capsules derived from Zingiber officinale Roscoe rhizome. Ingredient assays, batches and manufacturing details remain unverified.
- Dose: A 250 mg root equivalent per active capsule; 0.5, 1 and 1.5 g/day root equivalents, taken 2 times daily. Root-equivalent and active-ingredient amounts are not converted.
- Comparator: The same antiemetics plus carrier-matched placebo. Actual arm-specific concomitant/rescue treatment, adherence and changes remain unverified.
- Measured outcome: Change in mean evening/night day-one NAv on a 7-point scale within the first 24 hours. The adjusted pooled change contrast is not converted into individual-dose effects, within-arm changes or other endpoints.
- Duration: For 6 days per chemotherapy cycle, starting 3 days before chemotherapy, over 2 cycles. Actual cycle/visit-specific exposure and denominators remain unverified.
- Questions outside this scope: Stopping/replacing standard antiemetics or effects of ginger alone; Extending pooled results to individual-dose efficacy, optimal dose or dose superiority; Equivalent conversion or direct superiority claims between the standardized 84 mg active-compound formulation and root-equivalent amounts; Substituting delayed nausea, vomiting, grade 3 nausea or quality of life for mean NAv in the first 24 hours; Establishing overall efficacy/safety for long-term exposure, rare events or vulnerable populations

## Checklist items

### N01 · Which add-on treatment and nausea question in the first 24 hours are covered?

Verification status: Met  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original claim is reduced acute nausea severity in the first 24 hours after chemotherapy. Aphios purified liquid extract in olive-oil carrier capsules is added to existing 5-HT3 plus corticosteroid treatment and compared with carrier-matched placebo; the selected outcome is the mean evening/night day-one score on a 7-point NAv scale. The three doses remain within the same pooled comparison.
- Why unverified: The original question and its boundaries are directly linked; this verifies question identity, without proving efficacy or confirming each dose's effect.
- Reason for missing information: The additional detailed-claim list is empty; independent dose-specific efficacy claims are absent from the current original wording.
- Required materials and conditions: The same Aphios liquid product, adults with prior chemotherapy nausea, common antiemetics, carrier placebo and the NAv definition
- Materials to obtain first: The original question boundary and corresponding trial eligibility criteria
- Further research: Material needed: The original question boundary and corresponding trial eligibility criteria. This records needed materials; no new research was executed.
- Conditions for verification: Linkage of the original claim and intervention/population descriptions to the selected main question's intervention, population, timing, endpoint and comparator
- Why this condition is needed: Needed to keep formulation, population and acute NAv separate from other ginger efficacy questions.
- Application exceptions: Do not turn dose-specific efficacy, delayed nausea or vomiting into the current main question.
- Remaining uncertainty: Question identity and sufficient results are separate matters.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N02 · How are the two reports and review references related?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The 2 retained report summaries and 2 bibliographies describe the 2012 Ryan/URCC CCOP dose-ranging trial and the 2024 Crichton standardized-formulation trial. Reviews from 2019–2025 are mentioned in the narrative, but individual bibliographies and inclusion tables are absent.
- Why unverified: Report links are retained, but external originals needed to establish overlap among unique trials, related reports and review inclusions are unavailable.
- Reason for missing information: The 2 reports do not establish 2 unique studies or 2 independent replications.
- Required materials and conditions: Paper/registration identifiers, related reports, included trials in reviews and endpoint-specific links
- Materials to obtain first: Related Ryan/Crichton reports and review inclusion-trial mapping
- Further research: Material needed: Related Ryan/Crichton reports and review inclusion-trial mapping. This records needed materials; no new research was executed.
- Conditions for verification: Report, registration and inclusion tables establishing unique trial identity and overlap/inclusion relationships
- Why this condition is needed: Needed to avoid counting the 2012 dose groups, 2024 report and review recitations as independent replications.
- Application exceptions: Do not establish unique trial or participant counts from registration strings or report counts alone.
- Remaining uncertainty: Related registration, repeat reports of the same participants and overlap of included trials remain unverified.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N03 · What was actually read, and what remains unread?

Verification status: Met  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: Actual reading in the retained preparation covered the complete stored summary for case 3048. The two papers were linked through PubMed bibliographies; external abstracts, full texts, registration and plans were neither accessed nor read. The 5 local method HTML files were checked only through whole-byte copying/hashes; their full contents were not reread.
- Why unverified: Stored-summary reading, unread external material, no access attempt and link presence are separated. This does not establish completed clinical validation of material content.
- Reason for missing information: External full text, registration, protocols and original disclosures remain unread/unacquired; no failed access attempt occurred.
- Required materials and conditions: Actual access, acquisition and reading histories for the stored summary, external papers/abstracts, registration and protocols
- Materials to obtain first: Reading records, safe original-source links and subsequent acquisition records
- Further research: Material needed: Reading records, safe original-source links and subsequent acquisition records. This records needed materials; no new research was executed.
- Conditions for verification: Distinction between actual local inputs read, dates, locations and hashes, and external material not accessed or read
- Why this condition is needed: Needed to separate the stored-summary reading badge from unread external full text.
- Application exceptions: Do not label external material that was never accessed as inaccessible or read.
- Remaining uncertainty: Historical verdict dates or verification wording do not prove the reading level in this preparation.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N04 · How specific was the 2012 population with prior chemotherapy nausea?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original population is adults with prior chemotherapy nausea who continued common 5-HT3 antagonists plus corticosteroids. This stored summary lacks details on cancer types, chemotherapy, eligibility/exclusions and arm-specific baseline nausea risk.
- Why unverified: The population definition is known, but tables establishing the scope of actual recruitment and baseline characteristics are unavailable.
- Reason for missing information: Detailed recruitment/baseline information is unrecorded in the specified stored summary; this does not mean it was unreported throughout the paper.
- Required materials and conditions: Prior chemotherapy nausea, adult cancer patients, cancer types/chemotherapy, baseline nausea, eligibility/exclusions and baseline risk
- Materials to obtain first: The 2012 recruitment/baseline table and cancer-type, chemotherapy and nausea-risk specifications
- Further research: Material needed: The 2012 recruitment/baseline table and cancer-type, chemotherapy and nausea-risk specifications. This records needed materials; no new research was executed.
- Conditions for verification: Eligibility/exclusions, cancer types, chemotherapy, baseline nausea and group composition
- Why this condition is needed: Needed to avoid extrapolation to populations with other chemotherapy nausea risks or antiemetic regimens.
- Application exceptions: Do not fill in actual characteristics of the 2024 study population from the intervention/population description of this question.
- Remaining uncertainty: Applicability of the same result to other cancer types, chemotherapy regimens and nausea-risk populations remains unverified.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N05 · What formulation were the Aphios liquid extract and carrier?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original intervention is Aphios purified liquid ginger extract in olive-oil carrier capsules, given orally as an add-on and derived from Zingiber officinale Roscoe rhizome. The retained report names Aphios manufacturing but lacks batch-specific active-ingredient, assay and purification specifications.
- Why unverified: Formulation/source names are identified, but root-equivalent definitions and reproducibility of active ingredients/manufacturing batches cannot be established from the summary alone.
- Reason for missing information: Root-equivalent definitions, gingerol/shogaol assays and manufacturing/batch test certificates remain unverified.
- Required materials and conditions: Purified liquid extract, olive-oil carrier, capsules, source/ingredient assays, manufacturing and batches
- Materials to obtain first: Aphios manufacturing specifications, ingredient assays, root-equivalent definitions and carrier composition
- Further research: Material needed: Aphios manufacturing specifications, ingredient assays, root-equivalent definitions and carrier composition. This records needed materials; no new research was executed.
- Conditions for verification: Material on actual manufacturing, root-equivalent definitions and active ingredients/batches
- Why this condition is needed: Needed to distinguish root-equivalent amounts from standardized active-ingredient amounts or powder.
- Application exceptions: Product and manufacturer names alone do not certify ingredient assays or matching batches.
- Remaining uncertainty: This does not establish equivalence or superiority to powder or the standardized 84 mg formulation.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N06 · What was added to 5-HT3 antagonists and corticosteroids?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original question compares the same antiemetics plus carrier-matched placebo. Ginger is added to background 5-HT3 antagonists and corticosteroids in both arms. Actual arm-specific antiemetic types/doses, rescue treatment, adherence and changes remain unverified.
- Why unverified: Common treatment, added ingredient and placebo are separated, but actual arm-specific concomitant treatment/deviations are unspecified.
- Reason for missing information: Details of rescue antiemetics, actual adherence/changes and placebo ingredients are unrecorded.
- Required materials and conditions: Common antiemetics, matched carrier placebo, arm-specific antiemetic/rescue treatment, adherence and changes
- Materials to obtain first: 5-HT3/corticosteroid treatment, placebo ingredients, rescue antiemetics and group-specific changes
- Further research: Material needed: 5-HT3/corticosteroid treatment, placebo ingredients, rescue antiemetics and group-specific changes. This records needed materials; no new research was executed.
- Conditions for verification: Arm-specific specifications of common treatment, carrier placebo, rescue treatment and actual adherence/changes
- Why this condition is needed: Needed to avoid attributing standard antiemetic effects or arm-specific concomitant-treatment differences to ginger.
- Application exceptions: Do not convert an add-on study into antiemetic replacement or a comparison of ginger alone.
- Remaining uncertainty: Do not interpret an add-on as replacement of standard antiemetics or an effect of ginger alone.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N07 · What were the denominator, NAv and interval for the 0.5 g/day root-equivalent arm?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original dose list includes 0.5 g/day root equivalents. This arm's allocation/analysis/completion, NAv effect, 95% CI, cycle/visit-specific denominators and placebo contrast are not established in the stored summary.
- Why unverified: Presence of a dose differs from verification of its arm-specific results/denominators. The pooled −0.350 points and 744/576 were not copied into this arm.
- Reason for missing information: The 0.5 g arm's own denominators, effects, CIs and time-specific contrasts all remain unverified.
- Required materials and conditions: Allocation/analysis/completion, NAv estimate, CI, cycles/visits and placebo contrast for the 0.5 g/day arm
- Materials to obtain first: Results, flow, analysis specifications and the comparator CI for the 0.5 g arm
- Further research: Material needed: Results, flow, analysis specifications and the comparator CI for the 0.5 g arm. This records needed materials; no new research was executed.
- Conditions for verification: Denominators, NAv results, intervals and comparison definitions explicitly attributable to the 0.5 g arm
- Why this condition is needed: Needed to retain an original dose stratum without copying the pooled estimate into it.
- Application exceptions: Do not use the overall −0.350 and 744/576 as this arm's effect or denominator.
- Remaining uncertainty: A positive pooled signal does not establish an effect for the 0.5 g arm or an optimal dose.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N08 · What were the denominator, NAv and interval for the 1 g/day root-equivalent arm?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original dose list includes 1 g/day root equivalents. This arm's allocation/analysis/completion, NAv effect, 95% CI, cycle/visit-specific denominators and placebo contrast are not established in the stored summary.
- Why unverified: The middle dose has no individual estimate; pooled results were not substituted for its results.
- Reason for missing information: The 1 g arm's own denominators, effects, CIs and time-specific contrasts all remain unverified.
- Required materials and conditions: Allocation/analysis/completion, NAv estimate, CI, cycles/visits and placebo contrast for the 1 g/day arm
- Materials to obtain first: Results, flow, analysis specifications and the comparator CI for the 1 g arm
- Further research: Material needed: Results, flow, analysis specifications and the comparator CI for the 1 g arm. This records needed materials; no new research was executed.
- Conditions for verification: Denominators, NAv results, intervals and comparison definitions explicitly attributable to the 1 g arm
- Why this condition is needed: Needed to distinguish the original middle dose stratum from the pooled result.
- Application exceptions: Do not use the overall −0.350 and 744/576 as this arm's effect or denominator.
- Remaining uncertainty: Significance in another dose or pooled comparison does not prove an individual effect in the 1 g arm.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N09 · What were the denominator, NAv and interval for the 1.5 g/day root-equivalent arm?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original dose list includes 1.5 g/day root equivalents. This arm's allocation/analysis/completion, NAv effect, 95% CI, cycle/visit-specific denominators and placebo contrast are not established in the stored summary.
- Why unverified: The higher dose has no individual estimate; pooled results were not substituted for its results.
- Reason for missing information: The 1.5 g arm's own denominators, effects, CIs and time-specific contrasts all remain unverified.
- Required materials and conditions: Allocation/analysis/completion, NAv estimate, CI, cycles/visits and placebo contrast for the 1.5 g/day arm
- Materials to obtain first: Results, flow, analysis specifications and the comparator CI for the 1.5 g arm
- Further research: Material needed: Results, flow, analysis specifications and the comparator CI for the 1.5 g arm. This records needed materials; no new research was executed.
- Conditions for verification: Denominators, NAv results, intervals and comparison definitions explicitly attributable to the 1.5 g arm
- Why this condition is needed: Needed to distinguish the original higher dose stratum from the pooled result.
- Application exceptions: Do not use the overall −0.350 and 744/576 as this arm's effect or denominator.
- Remaining uncertainty: A higher listed dose alone does not establish greater efficacy or dose superiority.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N10 · Does the material answer direct differences among the three doses or optimal dose?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The 2012 report is a randomized multicenter dose-ranging trial; the three-dose list and overall pooled result are retained. Direct between-dose effect differences, CIs, interactions/prespecified contrasts and multiple-comparison specifications are absent.
- Why unverified: A dose-ranging title does not replace verification of direct superiority estimates or optimal-dose results.
- Reason for missing information: Direct 0.5 versus 1 versus 1.5 g comparisons/interactions, intervals and plans remain unverified.
- Required materials and conditions: Prespecified between-dose contrasts, interaction, multiple comparisons, arm-specific estimates and CIs
- Materials to obtain first: Original dose-specific contrast tables, multiplicity plans and dose-response analyses
- Further research: Material needed: Original dose-specific contrast tables, multiplicity plans and dose-response analyses. This records needed materials; no new research was executed.
- Conditions for verification: Evidence for direct contrasts among the three doses, test plans, interactions and intervals
- Why this condition is needed: Needed to avoid extending pooled significance into efficacy of every dose or dose superiority.
- Application exceptions: Do not force proof of an optimal dose as a requirement for the main pooled-NAv question.
- Remaining uncertainty: This supplementary gap does not justify splitting the main pooled question into three efficacy tables.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N11 · What was the pre-chemotherapy start and two-cycle schedule?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The intervention description records 250 mg root equivalent per active capsule, 2 daily doses, starting 3 days before chemotherapy, 6 days in each cycle and two cycles. Actual cycle-specific intake, adherence and chemotherapy/measurement dates are not established in detail.
- Why unverified: The original planned exposure schedule is identified, but concordance of actual intake and timing cannot be established from this input alone.
- Reason for missing information: Medication diaries, actual exposure/visits and cycle-specific adherence remain unverified.
- Required materials and conditions: Root equivalent of 250 mg per active capsule, 2 daily doses, starting 3 days before chemotherapy, 6 days per cycle, 2 cycles and actual intake
- Materials to obtain first: Cycle-specific intake, chemotherapy dates and actual adherence/intake-frequency records
- Further research: Material needed: Cycle-specific intake, chemotherapy dates and actual adherence/intake-frequency records. This records needed materials; no new research was executed.
- Conditions for verification: Records linking prescribed schedules and actual intake with chemotherapy and measurement dates
- Why this condition is needed: Needed to avoid attributing differences in efficacy across formulations to timing/duration differences alone.
- Application exceptions: A prescribed schedule does not prove actual intake, adherence or effects in each of the two cycles.
- Remaining uncertainty: Do not extend the 6-day cycle schedule and 2 cycles into delayed/long-term persistence or independent replication in individual cycles.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N12 · What scale and visits define NAv in the first 24 hours?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The selected endpoint is change in mean evening/night day-one NAv on a 7-point scale; the original claim concerns acute nausea intensity within the first 24 hours. Baseline, averaging rules, score direction and diary definitions are not specified in detail in the retained summary.
- Why unverified: Scale/time labels and the mean-change definition are present, but actual baseline, measurement and calculation specifications are absent.
- Reason for missing information: NAv baseline visit, detailed time window, score direction and calculation rules remain unverified.
- Required materials and conditions: Mean evening/night day-one scores on a 7-point scale, baseline, change definition, measurement window and score direction
- Materials to obtain first: Diaries, scale description, visit schedule and NAv calculation definitions
- Further research: Material needed: Diaries, scale description, visit schedule and NAv calculation definitions. This records needed materials; no new research was executed.
- Conditions for verification: Specifications of NAv, baseline, measurement window and averaging/change formulas
- Why this condition is needed: Needed to distinguish mean nausea intensity from vomiting events or proportions with severe nausea.
- Application exceptions: Do not infer score direction, averaging rules or baseline visits absent from the original record.
- Remaining uncertainty: Mean 7-point NAv, proportions with severe acute nausea and vomiting events are different outcomes.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N13 · Can allocation and baseline balance in the 2012 dose-ranging trial be verified?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The retained 2012 design is a randomized double-blind multicenter dose-ranging trial. Details of sequence generation/concealment, parallel/crossover/cluster structure and arm-specific baseline balance are absent from the summary.
- Why unverified: The RCT title is retained without substituting it for verification of actual allocation, structure or baseline balance.
- Reason for missing information: Allocation/concealment, detailed design and baseline tables remain unverified; they are not recast as not applicable.
- Required materials and conditions: Randomized/multicenter design, parallel/crossover structure, sequence generation/concealment and arm-specific baseline balance
- Materials to obtain first: Methods, allocation procedures and arm-specific baseline tables
- Further research: Material needed: Methods, allocation procedures and arm-specific baseline tables. This records needed materials; no new research was executed.
- Conditions for verification: Methods material on actual allocation/concealment, trial structure and baseline characteristics
- Why this condition is needed: Needed to avoid judging allocation procedures as problem-free from a randomized label alone.
- Application exceptions: Do not replace unverified design details with crossover/cluster not-applicable labels.
- Remaining uncertainty: This work does not newly judge allocation procedures as problematic or problem-free.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N14 · How were double blinding and nausea measurement performed?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The 2012 report names double blinding; the original question uses carrier-matched placebo and subjective NAv measurement. Blinded parties/success, diary collection, flavor matching and group-specific measurement missingness remain unverified.
- Why unverified: The double-blind label is separated from actual nausea measurement conditions, without claiming verification of all procedures.
- Reason for missing information: Actual blinding/diary collection and group-specific measurement limitations remain unverified.
- Required materials and conditions: Participant/staff/assessor blinding, carrier/flavor matching, diary collection and group-specific measurement missingness
- Materials to obtain first: Blinding/diary-collection methods, measurement-data quality and group-specific missingness
- Further research: Material needed: Blinding/diary-collection methods, measurement-data quality and group-specific missingness. This records needed materials; no new research was executed.
- Conditions for verification: Specifications of blinded parties, placebo matching, diary collection and measurement limitations
- Why this condition is needed: Needed to separate subjective nausea measurement/blinding conditions from effect magnitude.
- Application exceptions: A double-blind label does not verify every measurement procedure or successful blinding.
- Remaining uncertainty: This input does not establish how far measurement differences explain the actual result.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N15 · What do 744 allocated and 576 analyzed represent?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The retained 2012 counts are 744 randomized and 576 analyzed. Completion counts, group/cycle-specific denominator roles and exclusion/withdrawal reasons are not recorded in detail.
- Why unverified: The allocation/analysis roles of the original numbers are retained, but 576 is not established as a completer, arm-specific, visit-specific or harm denominator.
- Reason for missing information: Arm-specific allocation/completion/analysis, exclusion reasons and the actual analysis population remain unverified.
- Required materials and conditions: Roles of overall allocation, analysis, completion and withdrawal counts, arm-specific flow and original count definitions
- Materials to obtain first: Overall/group-specific allocation, analysis and completion flow with exclusion reasons
- Further research: Material needed: Overall/group-specific allocation, analysis and completion flow with exclusion reasons. This records needed materials; no new research was executed.
- Conditions for verification: Material establishing each number's analysis/completion role and arm-specific participant flow
- Why this condition is needed: Needed to avoid turning overall counts into dose-arm, individual-visit or completer denominators.
- Application exceptions: Do not newly calculate the difference between 744 and 576 as withdrawals with established reasons or a harm denominator.
- Remaining uncertainty: Do not newly calculate count differences as withdrawal causes or event counts.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N16 · What were NAv denominators for each cycle and evening/night visit?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original schedule has two chemotherapy cycles, with mean evening/night day-one NAv as the outcome. Actual measured/analyzed denominators by dose, cycle and visit and specifications for combining repeated measurements are absent from the stored summary.
- Why unverified: This outcome unit remains unverified because the overall 576 cannot be copied into each cycle and evening/night denominator.
- Reason for missing information: Cycle/visit/dose-specific denominators and repeated-measures handling remain unverified.
- Required materials and conditions: Dose-by-cycle-by-evening/night measurement/analysis denominators and repeated-measures structure
- Materials to obtain first: Cycle/visit-specific NAv analysis tables and arm-specific measurement-completion specifications
- Further research: Material needed: Cycle/visit-specific NAv analysis tables and arm-specific measurement-completion specifications. This records needed materials; no new research was executed.
- Conditions for verification: Specifications of actual time/cycle-specific outcomes, denominators and repeated-measures handling
- Why this condition is needed: Needed to avoid reusing the overall 576 for all cycle/visit denominators.
- Application exceptions: Do not count two cycles in the same people as two independent trials or add them into unique-participant totals.
- Remaining uncertainty: Do not add two cycles in the same people as independent trials or unique participants.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N17 · How were missingness and intake deviations handled in the 2012 analysis?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The retained 2012 summary reports limited completion data and 576 analyzed participants. ITT/PP/completer definitions, missingness/adherence handling, rescue treatment and sensitivity analyses are not recorded in detail.
- Why unverified: The 2012 estimand and missingness handling are unavailable, so the 2024 ITT label was not inherited by the 2012 analysis.
- Reason for missing information: The 2012 analysis population, missingness causes/imputation/sensitivity and intake-deviation handling remain unverified.
- Required materials and conditions: ITT/PP/completer status, missingness causes/handling, adherence, assignment/adherence effects and sensitivity
- Materials to obtain first: The 2012 SAP, analysis-population/missingness/adherence and sensitivity specifications
- Further research: Material needed: The 2012 SAP, analysis-population/missingness/adherence and sensitivity specifications. This records needed materials; no new research was executed.
- Conditions for verification: Material on the estimand, analysis population, missingness/deviation handling and sensitivity
- Why this condition is needed: Needed to avoid establishing ITT or an adherence effect from the count of 576 analyzed alone.
- Application exceptions: Do not automatically apply the 2024 ITT label to the 2012 analysis population.
- Remaining uncertainty: Limited completion data do not establish a new missingness-effect magnitude or validity judgment.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N18 · Which comparison, adjustment and pooled estimate does −0.350 points represent?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The 2012 result is the pooled-all-dose adjusted NAv change contrast of −0.350 points, P=.013, with exact 95% CI retained as unverified. Detailed comparison, adjustment, baseline and cycle-combination model specifications are absent.
- Why unverified: The selected pooled result is explicit in the retained record, but complete specifications of the target comparison, adjustment variables and pooling are absent.
- Reason for missing information: The model, covariates, dose/cycle pooling weights and baseline remain unverified.
- Required materials and conditions: The pooled-all-dose adjusted NAv change contrast, placebo comparison, baseline, model/covariates and cycle combination
- Materials to obtain first: Original result tables, adjustment model and contrast/cycle/weight specifications
- Further research: Material needed: Original result tables, adjustment model and contrast/cycle/weight specifications. This records needed materials; no new research was executed.
- Conditions for verification: Specifications of the target comparison, change/adjustment definition, dose pooling and original results
- Why this condition is needed: Needed to distinguish an adjusted pooled value from individual-arm values, within-arm changes and unadjusted effects.
- Application exceptions: Do not reconstruct pooling weights or models not explained in the original record.
- Remaining uncertainty: Do not substitute individual-dose effects, within-arm change or an unadjusted difference, or calculate a new effect.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N19 · Can the exact 95% CI and an important nausea difference be interpreted?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original record reports a pooled −0.350 points, P=.013, and explicitly leaves the exact 95% CI unverified. Variance and criteria for a clinically important NAv difference are absent from this input.
- Why unverified: P values and a large overall sample do not establish the CI or clinical importance; no back-calculation was performed.
- Reason for missing information: The selected estimate's exact CI, variance and importance criteria remain unverified.
- Required materials and conditions: The exact CI, variance, denominator and clinical important-difference evidence for −0.350
- Materials to obtain first: Exact CI/SE/variance, NAv clinical-importance evidence and original analysis tables
- Further research: Material needed: Exact CI/SE/variance, NAv clinical-importance evidence and original analysis tables. This records needed materials; no new research was executed.
- Conditions for verification: The selected pooled estimate's exact CI and justified importance criteria
- Why this condition is needed: Needed to avoid establishing precision or clinical importance from P values/sample size alone.
- Application exceptions: Do not back-calculate a CI from P=.013 or adopt arbitrary importance differences/minimum sample sizes.
- Remaining uncertainty: Do not newly grade an effect as present/absent or set arbitrary minimum sample sizes or important differences.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N20 · What is the conflict between the paper and current registration's primary endpoint (1st in the hierarchy)?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original answer/grade explanation reports a conflict between the paper and current registration's primary endpoint (1st in the hierarchy). The actual endpoint wordings, registration versions/timing and protocol/SAP were not read in the retained preparation.
- Why unverified: The historical report of a conflict is retained without labeling current independent original-source comparison as successful or selective reporting as established.
- Reason for missing information: Comparison of actual paper/registration endpoint wording, timing and change reasons was not performed.
- Required materials and conditions: The historically reported hierarchy conflict, registration versions/timing, protocol/SAP and paper endpoints
- Materials to obtain first: Timestamped registration versions, protocol, SAP and the paper's results section
- Further research: Material needed: Timestamped registration versions, protocol, SAP and the paper's results section. This records needed materials; no new research was executed.
- Conditions for verification: Comparison establishing actual paper/registration endpoint definitions, timing and reasons for changes
- Why this condition is needed: Needed to avoid turning a reported registration-hierarchy conflict into successful new source comparison or established selective reporting.
- Application exceptions: The recorded selected endpoint does not prove a registered primary endpoint (1st in the hierarchy).
- Remaining uncertainty: The recorded selected endpoint does not establish the representative NAv as the registered primary endpoint (1st in the hierarchy).
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N21 · What do NCT00040742 and an unverified registration status mean?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original registration status is unverified, while the bibliography contains NCT00040742. Both original values are retained; the registration text remains unread, with no access attempt.
- Why unverified: A bibliographic identifier string differs from actual registration verification; the original registration-status field was not automatically corrected.
- Reason for missing information: Original registration, related trial family and versions were not verified; this does not mean unregistered.
- Required materials and conditions: The bibliographic NCT string, original registration-status value and actual verification/access level
- Materials to obtain first: Original NCT00040742 registration and report-linkage evidence
- Further research: Material needed: Original NCT00040742 registration and report-linkage evidence. This records needed materials; no new research was executed.
- Conditions for verification: Specifications of the registration identifier, external verification history and paper/registration family relationships
- Why this condition is needed: Needed to distinguish a bibliographic identifier from reading the original registration.
- Application exceptions: Do not change unverified status into unregistered status or absence of an NCT string.
- Remaining uncertainty: Do not turn the difference between the fields into a new conclusion that the registration is absent or wrong.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N22 · What related material is the Crichton 2024 report?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The 2024 title and Crichton J Acad Nutr Diet bibliography, PMID37699474 and DOI10.1016/j.jand.2023.09.003 are retained. External reports, registration and related families were not read in this preparation.
- Why unverified: A related report's identity is linked to the original bibliography, but material certifying independent replication of the same formulation/population/endpoint is unavailable.
- Reason for missing information: Related registration/reports, unique trial family and participant relationships remain unverified.
- Required materials and conditions: PMID37699474, DOI, report title, related registration/reports and unique trial family
- Materials to obtain first: The 2024 report, registration, protocol and related-report family table
- Further research: Material needed: The 2024 report, registration, protocol and related-report family table. This records needed materials; no new research was executed.
- Conditions for verification: Linkage of this report's bibliography, related registration, intervention/endpoint and trial family
- Why this condition is needed: Needed to avoid counting a newer report as independent replication of the same Aphios formulation.
- Application exceptions: A different report identifier does not certify matching formulation, population or estimand.
- Remaining uncertainty: Separate bibliographies are not labeled independent replication of the same Aphios formulation.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R02

### N23 · Is the standardized formulation with 84 mg active compounds the same as Aphios?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The 2024 report title describes standardized ginger root powder, and the retained research explanation mentions a standardized trial with 84 mg active compounds. The original crux retains differences in timing and active-compound amounts. These were not converted into equivalent Aphios root-equivalent grams.
- Why unverified: Formulation differences and the 84 mg reference are identified, but detailed 2024 manufacturing, root amounts, dose and start schedule are unavailable.
- Reason for missing information: The 2024 composition/root-equivalent amount, actual dose/start time and manufacturing batches remain unverified.
- Required materials and conditions: Standardized ginger root powder, the 84 mg active-compound reference, manufacturing, composition, dose and start time
- Materials to obtain first: The 2024 composition, dose, intake/start-date material and manufacturing specifications for both formulations
- Further research: Material needed: The 2024 composition, dose, intake/start-date material and manufacturing specifications for both formulations. This records needed materials; no new research was executed.
- Conditions for verification: Actual 2024 ingredients, active/root amounts, dose and start schedule compared with Aphios conditions
- Why this condition is needed: Needed to distinguish root-equivalent grams from active-ingredient milligrams and formulation differences.
- Application exceptions: Do not convert 84 mg into 0.5/1/1.5 g root equivalents or claim direct formulation superiority.
- Remaining uncertainty: Do not convert 84 mg active compounds into 0.5/1/1.5 g root equivalents or direct formulation superiority.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N24 · Were the 2024 population and concomitant treatment the same as the original question?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: Adults with prior chemotherapy nausea and 5-HT3 plus corticosteroids in the retained intervention/population description define the original question. The 2024 summary describes a multicenter ITT trial but lacks exact recruitment/baseline and background/rescue-treatment details.
- Why unverified: The original question's population/treatment cannot be automatically inserted as actual 2024 study information.
- Reason for missing information: The 2024 eligibility, cancer types/chemotherapy, prior nausea/baseline risk and arm-specific concomitant/rescue treatment remain unverified.
- Required materials and conditions: The 2024 eligibility, cancer types/chemotherapy, prior nausea, baseline risk and background antiemetic/rescue treatment
- Materials to obtain first: The 2024 recruitment/baseline characteristics and chemotherapy, antiemetic and rescue-treatment specifications
- Further research: Material needed: The 2024 recruitment/baseline characteristics and chemotherapy, antiemetic and rescue-treatment specifications. This records needed materials; no new research was executed.
- Conditions for verification: Material comparing the actual 2024 population and arm-specific common treatment/changes with the original question
- Why this condition is needed: Needed to avoid transferring the 2012 target population/intervention description into actual 2024 eligibility information.
- Application exceptions: Absent 2024 population details do not establish that it was a different population.
- Remaining uncertainty: Unverified information establishes neither identical nor different populations across the trials.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R02

### N25 · Which analysis do 103 participants and 52 versus 51 represent?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The retained 2024 counts are 103 participants, 52 versus 51, and the design is an ITT randomized multicenter trial. Detailed allocation/analysis/completion roles, arm mapping and acute-CINV/QoL/visit-specific denominators are absent.
- Why unverified: Overall/arm counts and the ITT label are retained without establishing them as specific acute-NAv denominators or arm-specific event counts.
- Reason for missing information: Arm mapping for 52/51, endpoint/time-specific denominators and missing-data handling remain unverified.
- Required materials and conditions: Allocation/analysis/completion roles, arm mapping, acute-CINV/QoL/cycle-specific denominators and ITT handling
- Materials to obtain first: The 2024 flow diagram, endpoint-specific denominators, arm mapping and ITT/missingness specifications
- Further research: Material needed: The 2024 flow diagram, endpoint-specific denominators, arm mapping and ITT/missingness specifications. This records needed materials; no new research was executed.
- Conditions for verification: Material establishing the roles of 103/52/51, outcome/time-specific analysis denominators and ITT handling
- Why this condition is needed: Needed to avoid converting overall/group counts into denominators for a specific acute-NAv analysis.
- Application exceptions: Do not infer ginger/placebo mapping for 52/51 or NAv analysis denominators.
- Remaining uncertainty: Do not recalculate separate effects, events or withdrawals from these counts or add them to 744/576.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R02

### N26 · How are primary QoL (1st) and secondary acute CINV (2nd) distinguished?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The retained 2024 endpoint hierarchy has nausea-related quality of life as primary (1st) and acute CINV as secondary (2nd). Actual registration/protocol, QoL/CINV scales, timing and multiplicity plans were not read in this preparation.
- Why unverified: The retained primary/secondary hierarchy is maintained without claiming external registration verification or identity with the representative NAv primary endpoint (1st).
- Reason for missing information: Actual QoL/CINV definitions, registration/plans, measurement windows and multiplicity comparisons remain unverified.
- Required materials and conditions: Nausea-related QoL as primary (1st), acute CINV as secondary (2nd), registration/analysis plans and definitions/timing
- Materials to obtain first: The 2024 registration/protocol, endpoint table and CINV definitions/timing
- Further research: Material needed: The 2024 registration/protocol, endpoint table and CINV definitions/timing. This records needed materials; no new research was executed.
- Conditions for verification: Specifications of QoL/CINV definitions, hierarchy, plans and actual results
- Why this condition is needed: Needed to avoid turning secondary acute CINV (2nd) into success/failure of the representative primary NAv endpoint (1st).
- Application exceptions: The hierarchy in the retained report is not a current verification of original registration content.
- Remaining uncertainty: Do not substitute another endpoint's hierarchy for the current NAv registration hierarchy.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R02

### N27 · What comparison underlies the report of no acute-CINV effect?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original 2024 result reports no acute-CINV effect, and its retained explanation reports null acute CINV after ITT and Bonferroni adjustment. Exact estimates/CIs, scales and denominators are absent from this summary.
- Why unverified: The contrary/null report is retained, but it concerns another standardized formulation and CINV definition; it is not used as proof of an Aphios NAv effect of 0 or equivalence.
- Reason for missing information: Exact acute-CINV effects/intervals, definitions, denominators and multiplicity details remain unverified.
- Required materials and conditions: ITT, Bonferroni adjustment, acute-CINV estimate/CI, scale/denominators and differences from the original NAv question
- Materials to obtain first: Acute-CINV result tables, multiplicity/ITT specifications and exact CIs
- Further research: Material needed: Acute-CINV result tables, multiplicity/ITT specifications and exact CIs. This records needed materials; no new research was executed.
- Conditions for verification: Adjusted acute-CINV effects/intervals, target comparison and differences from the NAv question
- Why this condition is needed: Needed to avoid deleting a recent null report or changing it into an effect of 0 for NAv with the same formulation.
- Application exceptions: Retain no-effect wording as a report in the original record; do not extend it to proof of equivalence or noninferiority.
- Remaining uncertainty: No effect is wording in the original record, not a new judgment of magnitude 0, equivalence or absence of all ginger effects.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R02

### N28 · Where do positive delayed-nausea and quality-of-life findings belong?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The 2024 results report positive delayed-nausea and quality-of-life findings. The retained scope/advertising-interpretation explanation separates delayed nausea, vomiting and QoL from nausea results in the first 24 hours.
- Why unverified: Positive findings at other times/for other outcomes are retained, but exact definitions, effects/CIs, duration and denominators are absent.
- Reason for missing information: Individual delayed-nausea/QoL effects, definitions, timing, denominators and CIs remain unverified.
- Required materials and conditions: Delayed-nausea/QoL definitions, timing, denominators, effects/CIs and outcomes separate from acute NAv
- Materials to obtain first: The 2024 delayed-nausea/QoL result tables and analysis/visit-specific denominators
- Further research: Material needed: The 2024 delayed-nausea/QoL result tables and analysis/visit-specific denominators. This records needed materials; no new research was executed.
- Conditions for verification: Definitions/timing, effects and intervals attributable separately to delayed nausea and QoL
- Why this condition is needed: Needed to avoid transferring positive findings from other time windows/outcomes into NAv benefit within the first 24 hours.
- Application exceptions: Retain positive findings for their own outcomes without erasing gaps in the current question.
- Remaining uncertainty: Do not use these positive reports to fill gaps in first 24 hours mean NAv or claim replacement of standard antiemetics.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R02

### N29 · What are the bibliographies and included trials of reviews from 2019–2025?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The retained research explanation reports comparisons of systematic reviews from 2019~2025. The current research/bibliography summaries contain only two individual-trial reports, without exact review bibliographies or inclusion/endpoint-contribution tables.
- Why unverified: No actual identifiers/inclusion specifications trace these synthesis references, so review counts, unique trials and overlap are not established.
- Reason for missing information: Each review's identity, search scope, included trials, overlap/endpoint contributions and corrections remain unverified.
- Required materials and conditions: Each review's exact bibliography, search criteria, included trials, overlapping families and endpoint-contribution tables
- Materials to obtain first: The 2019–2025 review bibliographies, inclusion tables, correction/search criteria and endpoint-specific material
- Further research: Material needed: The 2019–2025 review bibliographies, inclusion tables, correction/search criteria and endpoint-specific material. This records needed materials; no new research was executed.
- Conditions for verification: Exact bibliographies of the mentioned reviews, original included trials/endpoint contributions and overlap
- Why this condition is needed: Needed to avoid converting mentions of multiple years into unique review/trial counts or independent replications.
- Application exceptions: Do not invent review identities outside the 2 original research/bibliographic entries or add their counts.
- Remaining uncertainty: No search or unverified bibliography does not mean no reviews or 0 human studies.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: 

### N30 · Do severe acute-nausea or acute-vomiting signals answer NAv?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original counterview reports severe acute-nausea or acute-vomiting subgroup signals in recent reviews; the English counterview specifies grade 3 acute nausea/acute vomiting. The original record states that these scale/severity definitions differ from the representative mean NAv.
- Why unverified: Other-endpoint signals are retained, but exact bibliographies, contributing trials/denominators and estimates/CIs are unavailable, so they cannot be combined as the same NAv effect.
- Reason for missing information: Subgroup definitions, bibliographies, trial contributions/denominators and effects/CIs remain unverified.
- Required materials and conditions: Grade 3 nausea or vomiting, definitions/scales/timing, denominators, effects/CIs and differences from NAv
- Materials to obtain first: Review subgroup-result tables, severity definitions and contributing trials/denominators
- Further research: Material needed: Review subgroup-result tables, severity definitions and contributing trials/denominators. This records needed materials; no new research was executed.
- Conditions for verification: Material distinguishing review suboutcomes' endpoints, severity and measures from the original NAv definition
- Why this condition is needed: Needed to distinguish severity-subgroup and vomiting signals from effects on mean nausea intensity.
- Application exceptions: Retain other-endpoint signals without substituting them for first 24 hours NAv success.
- Remaining uncertainty: Do not substitute acute vomiting or grade 3 nausea for reduced mean NAv.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: 

### N31 · How far are NCI support and Aphios manufacturing verified?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The retained 2012 funding description states NCI support and Aphios manufacturing, and the original grade explanation cites independent NCI support as a strength. Details of product supply, employee authors, patents and actual COI declarations are not established in the stored summary.
- Why unverified: Funding/manufacturing reports are retained without claiming that NCI support excludes all conflicts or completes current independence verification.
- Reason for missing information: Original specifications of product supply, author employment/patents, declared COI and team independence remain unverified.
- Required materials and conditions: Support, product supply, manufacturing, employee authors/patents, declared COI and institutions/research teams
- Materials to obtain first: The 2012 funding/acknowledgments, affiliations/COI and Aphios product-supply specifications
- Further research: Material needed: The 2012 funding/acknowledgments, affiliations/COI and Aphios product-supply specifications. This records needed materials; no new research was executed.
- Conditions for verification: Separate actual disclosures of funding, manufacturing, product supply, employment/patents and COI
- Why this condition is needed: Needed to avoid inferring absent product support or author conflicts from NCI support alone.
- Application exceptions: Do not inherit the original I2 or independent-support wording as current certification of independence.
- Remaining uncertainty: Historical I2 and independent-support wording do not establish new table independence or absence of bias.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01

### N32 · How far are nongovernment support and author COI verified?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The retained 2024 funding description states nongovernment research support and separately checked author COI. This input lacks details of the supporting institutions, product supply, author employment/patents and declarations compared.
- Why unverified: The historical separately-checked wording is retained as an original report, without upgrading it to current disclosure verification, absence of conflicts or independent funding.
- Reason for missing information: Funding institutions, product/author/patent relationships and actual COI text remain unverified.
- Required materials and conditions: Funding institutions, product supply, employment/patents, declared COI and original-trial funding/independence
- Materials to obtain first: The 2024 funding, product/author relationships and original COI text
- Further research: Material needed: The 2024 funding, product/author relationships and original COI text. This records needed materials; no new research was executed.
- Conditions for verification: Actual 2024 support/supply, affiliations/patents and disclosed relationships
- Why this condition is needed: Needed to avoid changing nongovernment support into absence of conflicts or independent funding.
- Application exceptions: Historical wording that COI was checked separately does not establish reading the original declarations in this preparation.
- Remaining uncertainty: A nongovernment funding category alone does not establish result independence or absence of bias.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R02

### N33 · Were gastrointestinal discomfort and other harms actually collected as events?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original safety description provides caution about gastrointestinal discomfort and possible anticoagulant/antiplatelet interactions. The two report summaries lack actual group-specific specifications of harm-event definitions, collection/severity, discontinuation and missingness.
- Why unverified: Caution advice and actually observed harm events/systematic collection are different levels; event counts or completed collection are not claimed.
- Reason for missing information: Actual harm collection, definitions, severity and discontinuation are unrecorded within the summary read; this does not mean they were unreported throughout the papers.
- Required materials and conditions: Arm-specific event definitions, collection methods, severity, discontinuation, follow-up missingness and reporting scope
- Materials to obtain first: Each trial's adverse-event definitions, collection methods, group-specific tables and discontinuation records
- Further research: Material needed: Each trial's adverse-event definitions, collection methods, group-specific tables and discontinuation records. This records needed materials; no new research was executed.
- Conditions for verification: Actual specifications of harm events/collection, severity, missingness and discontinuation
- Why this condition is needed: Needed to avoid turning existing caution advice into event counts verified in a trial.
- Application exceptions: Caution wording alone does not establish absence of harm reporting throughout every paper.
- Remaining uncertainty: Do not change unverified harms into 0, no harm or established safety.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N34 · What were the arm-specific harm-event counts and exposure denominators?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The trials provide efficacy/study counts of 744 allocated and 576 analyzed, and 103 participants with 52 versus 51. Actual harm events, exposure/follow-up time, harm denominators and arm-specific comparisons are absent from the retained material.
- Why unverified: Efficacy denominators were not reused as harm denominators, and event counts, incidence and relative risks were not calculated.
- Reason for missing information: Harm-arm mapping, people/event counts, exposure time, denominators and comparative estimates remain unverified.
- Required materials and conditions: People/events with harms, exposure/follow-up time, arm-specific denominators and actual comparisons
- Materials to obtain first: Adverse-event analysis populations, exposure time, arm mapping and event/discontinuation tables
- Further research: Material needed: Adverse-event analysis populations, exposure time, arm mapping and event/discontinuation tables. This records needed materials; no new research was executed.
- Conditions for verification: Specifications of arm-specific harm counts, exposure time, denominators and comparative estimates
- Why this condition is needed: Needed to avoid reusing 744/576 or 103/52/51 as harm denominators.
- Application exceptions: Do not convert unverified comparisons/denominators into 0 events or safety.
- Remaining uncertainty: Study totals or 2 reports do not establish event frequencies or comparative risks.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N35 · Do anticoagulant/antiplatelet cautions describe observed interactions?

Verification status: Partly verified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original safety advice says to discuss possible anticoagulant/antiplatelet interactions with the oncology team. Common chemotherapy/antiemetics, actual anticoagulant/antiplatelet exposure/events and alternative causes are not established in detail.
- Why unverified: The retained caution is identified, but actual interaction cases, comparisons/denominators or causal proof are absent from this material.
- Reason for missing information: Concomitant drugs/events, alternative causes and original interaction evidence remain unverified.
- Required materials and conditions: Concomitant drugs, chemotherapy/antiemetics, interaction cases/denominators, alternative causes and original caution advice
- Materials to obtain first: Concomitant-drug specifications, actual interaction/event records and original safety evidence
- Further research: Material needed: Concomitant-drug specifications, actual interaction/event records and original safety evidence. This records needed materials; no new research was executed.
- Conditions for verification: Material on concurrent drugs/events, comparisons, alternative explanations and the original caution's basis
- Why this condition is needed: Needed to distinguish a possibility warning from an actual causal interaction.
- Application exceptions: Do not use caution wording as a finding that bleeding or interactions actually occurred during coadministration.
- Remaining uncertainty: Do not change a possible-risk caution into observed bleeding/interactions or newly issue personal medication instructions.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N36 · Are intake, event onset, recovery and re-exposure linked?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original schedule starts 3 days before chemotherapy and lasts 6 days per cycle for 2 cycles. This input lacks actual timelines of harm onset, recovery, withdrawal/re-exposure, latency or alternative causes.
- Why unverified: An efficacy dosing schedule alone cannot establish a harm timeline, causality or improvement after stopping.
- Reason for missing information: Event onset/recovery, withdrawal/re-exposure and alternative-cause timelines remain unverified.
- Required materials and conditions: Actual event onset/recovery, withdrawal/re-exposure, exposure dates, latency and alternative causes
- Materials to obtain first: Actual adverse-event timing, withdrawal/re-exposure and clinical-course records
- Further research: Material needed: Actual adverse-event timing, withdrawal/re-exposure and clinical-course records. This records needed materials; no new research was executed.
- Conditions for verification: Timeline material establishing events/exposure, withdrawal/recovery and alternative causes
- Why this condition is needed: Needed to avoid constructing harm timing or causality from pre-chemotherapy administration alone.
- Application exceptions: Do not infer improvement after withdrawal or worsening on re-exposure without an event timeline.
- Remaining uncertainty: Do not claim use of a causality tool or an established signal when even temporal order is unverified.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N37 · What harms and special populations are covered beyond two cycles?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The current question concerns nausea in the first 24 hours of two chemotherapy cycles. The original safety advice contains no long-term/rare-event or vulnerable-population-specific exposure/follow-up data.
- Why unverified: No direct material supports extending limited exposure/populations into overall safety; the supplementary gap is retained.
- Reason for missing information: Long-term/rare harms and follow-up by special populations/concomitant drugs remain unverified.
- Required materials and conditions: Long-term/rare events, other concomitant drugs/baseline risks, vulnerable populations and follow-up duration
- Materials to obtain first: Safety follow-up and exposure/event specifications by duration, concomitant treatment and population
- Further research: Material needed: Safety follow-up and exposure/event specifications by duration, concomitant treatment and population. This records needed materials; no new research was executed.
- Conditions for verification: Exposure, follow-up and event data directly attributable to long-term/rare harms or vulnerable populations
- Why this condition is needed: Needed to avoid extending limited cycles/populations into overall safety.
- Application exceptions: Do not force all rare-harm studies as requirements of the first 24 hours NAv question.
- Remaining uncertainty: This gap neither makes all long-term harm research mandatory for the current narrow NAv question nor establishes absence of effect.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N38 · Are reports of the same harm unique replications?

Verification status: Unverified  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The current material contains two efficacy reports and common safety caution wording, but no material linking the same unique harm case's reports, recitations and other independent events.
- Why unverified: The presence of 2 efficacy reports does not establish 2 independent repetitions of the same harm; unique harm-case counts were not established.
- Reason for missing information: Unique events, related reports and recitation/independent-replication families remain unverified.
- Required materials and conditions: Unique cases, report families, matching exposure/events, recitations and contrary records
- Materials to obtain first: Related original harm material, case-family tables and recitation/regulatory sources
- Further research: Material needed: Related original harm material, case-family tables and recitation/regulatory sources. This records needed materials; no new research was executed.
- Conditions for verification: Specifications establishing unique event/report families and recitation relationships
- Why this condition is needed: Needed to avoid counting shared caution wording or recitations of the same case as independent harm repetition.
- Application exceptions: The presence of 2 efficacy reports does not prove 2 occurrences of the same harm event.
- Remaining uncertainty: Do not label caution advice as newly certified regulatory warnings or proof of event repetition.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N39 · What are the historical evidence dates and scope of the retained review?

Verification status: Met  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original verdict date is 2026-09-08, and the correction history reports corrections to 2 English items on 2026-09-14. The retained review was a preservation conversion of the then-current original summary on 2026-10-06; no new clinical search or abstract/full-text, registration or retraction verification was performed.
- Why unverified: Original dates, correction date and local review are separated from searches/unread full text. This does not establish completed review of the latest literature.
- Reason for missing information: New searches and publication/retraction/registration checks were not performed; this does not mean 0 studies.
- Required materials and conditions: Original verdict date, correction date, actual review/reading scope, new searches and registration/retraction verification
- Materials to obtain first: The current original record/correction history and receipt of actual review scope
- Further research: Material needed: The current original record/correction history and receipt of actual review scope. This records needed materials; no new research was executed.
- Conditions for verification: Linkage of original dates, materials used and reading scope, no new search and the scope of statements about missing evidence
- Why this condition is needed: Needed to avoid overstating this conversion as exhaustive review of current literature/publication status.
- Application exceptions: Do not reuse 2026-09-08 or 2026-09-14 as full-text reading dates for this work.
- Remaining uncertainty: Do not use historical dates as current full-text verification dates.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N40 · How are generic English and the historical correction of 2 items preserved?

Verification status: Met  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: The original correction of 2026-09-14 reports replacing 2 generic English evidence-table items with specific translations. Generic descriptions remain in the English participant, funding, endpoint, result and weighting fields of the two current reports. Specific Korean values, literal English and the correction text were preserved separately.
- Why unverified: Exact preservation of the current Korean/English originals and historical correction report meets the frozen preservation criterion. This does not establish specific English translations or verification that the 2 corrected items were actually reflected; that comparison remains unverified.
- Reason for missing information: The 2 corrected items were not compared with actual revised originals/manifests.
- Required materials and conditions: Specific Korean values, retained English wording, complete correction history, revised-text/field comparisons and current original identity
- Materials to obtain first: Original correction specifications, revised originals and current original/field mapping
- Further research: Material needed: Original correction specifications, revised originals and current original/field mapping. This records needed materials; no new research was executed.
- Conditions for verification: Exact preservation of current Korean/English originals and the historical correction report at their respective locations
- Why this condition is needed: Needed to avoid using a historical correction report as evidence of current specific English wording or clinical validation.
- Application exceptions: Do not overwrite retained original English evidence or record new corrections merely because a reader translation is prepared.
- Remaining uncertainty: Do not silently replace generic English in retained originals or label historical corrections as verified.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

### N41 · Were C50, axes, empty values and historical verification wording preserved?

Verification status: Met  
Reading scope: The retained Korean/English summaries and case-specific conditions/application records were read. Linked external abstracts, full texts, registration and planning material remain unread, with no access attempt.

- Current findings: Original C50/caution, EX/CX/R1/I2/B1 axes, false-valued fields, empty override/review records, the empty additional detailed-claim list, existing URLs and Korean/English historical independent cross-check wording are preserved unchanged in the complete original record. Grade/score were not automatically inherited as this table's condition states.
- Why unverified: Historical-value/identity preservation is separated from new judgments or independent certification; Met verifies the text-preservation condition.
- Reason for missing information: Original empty values remain unchanged; they are not filled with evidence of new execution of the original calculations/independent verification.
- Required materials and conditions: Original grade/score/safety, axes, false/empty values, the additional detailed-claim list, existing URLs and historical cross-check wording
- Materials to obtain first: Original stored summary, current original selection and text-identity/history material
- Further research: Material needed: Original stored summary, current original selection and text-identity/history material. This records needed materials; no new research was executed.
- Conditions for verification: Separation of original complete values, identity, Korean/English and historical verification wording from generation of new judgments/scores
- Why this condition is needed: Needed to avoid inheriting previous evaluations as newly met conditions or current independent certification.
- Application exceptions: Do not fill EX/CX, false axes or empty review records with new values or favorable judgments.
- Remaining uncertainty: Met preservation status does not establish sufficient NAv efficacy evidence or current independent clinical verification.
- Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, support and harms in the retained reports. Detailed conditions are Chamgap's own application.
- Related sources: R01, R02

## Evidence and sources

### R01

Ryan et al. (2012): Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients

[PubMed](https://pubmed.ncbi.nlm.nih.gov/21818642/)

Materials actually read: Stored research/bibliographic summary read; external abstract, full text, registration and plans unread  
Findings recorded in the summary: There were 744 randomized and 576 analyzed. The pooled-all-dose adjusted NAv change contrast is −0.350 points, P=.013, with exact 95% CI unverified. Effects, denominators and intervals for 0.5, 1 and 1.5 g separately remain unverified. The paper/registration conflict over the primary endpoint (1st) is a historical report, not a current original-text comparison.  
Record level: Adjusted change contrast pooled across doses; distinguished from individual-dose effects  
Independent replication: The 2012 dose-ranging report is distinguished from the 2024 report of another standardized formulation. The 744 allocated/576 analyzed and 103 participants/52 versus 51 are not added together; cycles in the same people are not counted as independent replications. Exact identities/inclusion relationships of reviews from 2019–2025 and unique trial/participant counts remain unverified.

| Material | Public availability | Access status | Actually read | Notes |
|---|---|---|---|---|
| Stored existing review summary | Stored existing summary acquired | Local acquisition and reading | Stored summary read | The retained research/bibliographic summary was read. Ryan JL et al. Support Care Cancer. 2012;20:1479-1489. PMID: 21818642. PMCID: PMC3361530. DOI: 10.1007/s00520-011-1236-3. NCT00040742. Bibliographic NCT00040742 and PMC3361530 are identifiers; original registration status remains unverified. Identifier/link presence does not establish current reading of registration, abstract or full text. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |
| External article abstract | Bibliographic link retained; abstract availability unverified | Access not attempted | Unread | A PubMed bibliographic link is not an abstract-reading record. Current abstract availability was not newly verified. Bibliographic NCT00040742 and PMC3361530 are identifiers; original registration status remains unverified. Identifier/link presence does not establish current reading of registration, abstract or full text. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |
| External article full text | Bibliography retained; full-text availability unverified | Access not attempted | Unread | Bibliographic, DOI and any PMCID references do not establish full-text acquisition or reading. External full text remains unread. Bibliographic NCT00040742 and PMC3361530 are identifiers; original registration status remains unverified. Identifier/link presence does not establish current reading of registration, abstract or full text. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |
| External trial registration | Bibliographic identifier retained; actual registration unverified | Access not attempted | Unread | Bibliographic identity is distinguished from actual registration verification. Original registration, versions and timing remain unread. Bibliographic NCT00040742 and PMC3361530 are identifiers; original registration status remains unverified. Identifier/link presence does not establish current reading of registration, abstract or full text. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |
| Protocol/statistical-analysis-plan material needed (existence unverified) | Material needed; existence/public availability unverified | Access not attempted | Unread | Existence, public availability and prespecification of original protocols/analysis plans remain unverified; their contents are unread. Bibliographic NCT00040742 and PMC3361530 are identifiers; original registration status remains unverified. Identifier/link presence does not establish current reading of registration, abstract or full text. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |
| Manufacturing/composition/conflict material needed (existence unverified) | Material needed; existence/public availability unverified | Access not attempted | Unread | Detailed original manufacturing/composition/support/author-relationship or harm material is unacquired and unread. Needed-material slots are not counted as independent studies or harm cases. Bibliographic NCT00040742 and PMC3361530 are identifiers; original registration status remains unverified. Identifier/link presence does not establish current reading of registration, abstract or full text. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |

### R02

Crichton et al. (2024): Effect of a Standardized Ginger Root Powder Regimen on Chemotherapy-Induced Nausea and Vomiting: A Multicenter, Double-Blind, Placebo-Controlled Randomized Trial

[PubMed](https://pubmed.ncbi.nlm.nih.gov/37699474/)

Materials actually read: Stored research/bibliographic summary read; external abstract, full text, registration and plans unread  
Findings recorded in the summary: There were 103 participants, 52 versus 51; arm mapping and endpoint-specific denominators remain unverified. Nausea-related quality of life is primary (1st), acute CINV secondary (2nd). Null acute CINV after ITT/Bonferroni adjustment and positive delayed-nausea/quality-of-life findings are retained. This does not establish an exact effect or equivalence for the same Aphios NAv question.  
Record level: Related results for another formulation, endpoint and time window; not an exact NAv effect for the selected product  
Independent replication: The 2012 dose-ranging report is distinguished from the 2024 report of another standardized formulation. The 744 allocated/576 analyzed and 103 participants/52 versus 51 are not added together; cycles in the same people are not counted as independent replications. Exact identities/inclusion relationships of reviews from 2019–2025 and unique trial/participant counts remain unverified.

| Material | Public availability | Access status | Actually read | Notes |
|---|---|---|---|---|
| Stored existing review summary | Stored existing summary acquired | Local acquisition and reading | Stored summary read | The retained research/bibliographic summary was read. Crichton M et al. J Acad Nutr Diet. 2024;124:313-330.e6. PMID: 37699474. DOI: 10.1016/j.jand.2023.09.003. Registration identity and acquisition of an original full-text copy remain unverified. Shared historical research wording is not inherited as current external reading of this report. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |
| External article abstract | Bibliographic link retained; abstract availability unverified | Access not attempted | Unread | A PubMed bibliographic link is not an abstract-reading record. Current abstract availability was not newly verified. Registration identity and acquisition of an original full-text copy remain unverified. Shared historical research wording is not inherited as current external reading of this report. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |
| External article full text | Bibliography retained; full-text availability unverified | Access not attempted | Unread | Bibliographic, DOI and any PMCID references do not establish full-text acquisition or reading. External full text remains unread. Registration identity and acquisition of an original full-text copy remain unverified. Shared historical research wording is not inherited as current external reading of this report. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |
| External trial registration | Registration identifier, existence and public availability unverified | Access not attempted | Unread | Bibliographic identity is distinguished from actual registration verification. Original registration, versions and timing remain unread. Registration identity and acquisition of an original full-text copy remain unverified. Shared historical research wording is not inherited as current external reading of this report. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |
| Protocol/statistical-analysis-plan material needed (existence unverified) | Material needed; existence/public availability unverified | Access not attempted | Unread | Existence, public availability and prespecification of original protocols/analysis plans remain unverified; their contents are unread. Registration identity and acquisition of an original full-text copy remain unverified. Shared historical research wording is not inherited as current external reading of this report. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |
| Safety/conflict material needed (existence unverified) | Material needed; existence/public availability unverified | Access not attempted | Unread | Detailed original manufacturing/composition/support/author-relationship or harm material is unacquired and unread. Needed-material slots are not counted as independent studies or harm cases. Registration identity and acquisition of an original full-text copy remain unverified. Shared historical research wording is not inherited as current external reading of this report. The stored-material review record dated 2026-10-06 concerns local-summary/condition-application review, not new reading of external documents. The date 2026-09-08 is the original verdict date and is not changed into current full-text reading or completion of a new search. |

## 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. · Retained method-application records were reused. External originals were not reread and method 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. · Retained method-application records were reused. External originals were not reread and method 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. · Retained method-application records were reused. External originals were not reread and method 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. · Retained method-application records were reused. External originals were not reread and method 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. · Retained method-application records were reused. External originals were not reread and method 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: The selected condition for material, identity or preservation was verified; this does not establish efficacy success or independent clinical validation.
- 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

2026-10-25 · Public page/materials 1.0. The public view and materials were prepared from the existing 41 items. No new clinical search, verification-state change or scoring was performed.