# 500-mg dried ginger-powder capsules × Reduction of HbA1c in adults with established type 2 diabetes

Verdict 3051 · Evidence Check

Stored-material review date: 2026-10-06  
Original evidence cut-off: 2026-09-08  
Review-criteria version: 1.2  
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 type 2 diabetes who did not use insulin and continued existing oral glucose-lowering medication. Detailed eligibility and baseline characteristics are unverified.
- Ingredient, formulation and route: Oral 500 mg capsules of dried ginger rhizome powder. Gingerol/shogaol assay, manufacturing and quality are unverified.
- Dose: 1 g per dose, 2 times daily, 2 g/day total. Nominal powder quantity remains distinct from active-constituent assay or equivalent amounts for other products.
- Comparator: Wheat-flour placebo plus existing oral glucose-lowering medication. Details of arm-specific medication, changes, diet, activity and rescue treatment are unverified.
- Measured outcome: Absolute change in HbA1c at 10 weeks (percentage points). The retained record describes NF-κB as primary (1st) and HbA1c as secondary (2nd); registration/planning originals were not read in this work.
- Duration: 10 weeks of treatment. Actual adherence, post-treatment follow-up, long-term results and extension to special populations remain separately unverified.
- Questions outside this scope: Fasting glucose, insulin, HOMA-IR, weight and lipids do not substitute for HbA1c results.; The pooled MD of -0.41 percentage points is not transferred to a guaranteed effect for a particular product or person.; Stopping or reducing glucose-lowering medication, diabetes remission, complication prevention and clinical events require separate direct material.; Other doses, products, populations, long-term persistence and rare harms remain separately unverified.

## Checklist items

### N01 · Which type 2 diabetes population and 10-week endpoint comparison are being checked?

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 concerns HbA1c reduction in adults with established type 2 diabetes. The selected details connect HbA1c with dried ginger-powder 500 mg capsules, 2 g/day for 10 weeks, versus wheat-flour placebo plus existing oral glucose-lowering medication in adults with type 2 diabetes who did not use insulin and maintained oral medication.
- Why unverified: The question, population, intervention, comparator, timing and main boundary were identified within retained material. This is not a status of demonstrated efficacy.
- Reason for missing information: External eligibility and original-trial details are outside this boundary-identification status.
- Required materials and conditions: Current HbA1c claim, Korean/English intervention/population details, oral powder 2 g/day, 10 weeks, comparator and independent boundary
- Materials to obtain first: Current HbA1c claim, Korean/English intervention/population details, oral powder 2 g/day, 10 weeks, comparator and independent boundary
- Further research: Material needed: Current HbA1c claim, Korean/English intervention/population details, oral powder 2 g/day, 10 weeks, comparator and independent boundary. This records needed materials; no new research was executed.
- Conditions for verification: Keep the HbA1c question distinct from other endpoints, formulations and populations and link it to the original location.
- Why this condition is needed: Needed to read the original claim with the actual T2D and concomitant-medication contract
- Application exceptions: The Korean claim already specifies adults with established type 2 diabetes. Preserve nonuse of insulin, continued oral glucose-lowering medication and the 10-week HbA1c comparison. Retain only the main question without automatically generating independent claims for other endpoints, formulations or populations.
- Remaining uncertainty: The table organizes retained evidence for the selected endpoint and does not certify efficacy in all adults or products.
- 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: S02, S01

### N02 · Is the same direct trial counted again in another endpoint table?

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 direct report is The Effects of Ginger on Fasting Blood Sugar, Hemoglobin A1c, and Lipid Profiles in Patients with Type 2 Diabetes; PMID29344037, PMC5750786, DOI10.5812/ijem.57927, bibliographic NCT02666807. Table 3052 also uses this report and its 50 randomized/45 analyzed participants (23/22). LDL/HbA1c are different outcomes and are not added into 100/90.
- Why unverified: The historical record describes full reading of both retained records and agreement of report identity/denominator literals; external trial/participant details were not compared.
- Reason for missing information: Unique-trial/participant certification and endpoint-specific duplication details are unverified.
- Required materials and conditions: Direct-trial PMID/PMC/DOI, bibliographic NCT, report title and LDL/HbA1c correspondence
- Materials to obtain first: Direct-trial PMID/PMC/DOI, bibliographic NCT, report title and LDL/HbA1c correspondence
- Further research: Material needed: Direct-trial PMID/PMC/DOI, bibliographic NCT, report title and LDL/HbA1c correspondence. This records needed materials; no new research was executed.
- Conditions for verification: Link matching report identifiers across the endpoints while retaining endpoint-specific estimates and avoiding certification of unique trials or participants.
- Why this condition is needed: Needed to avoid adding the same sample as a new independent trial in different endpoint tables
- Application exceptions: Retain endpoint-specific results even when the endpoints use the same trial report. Table/report counts are not unique-trial counts.
- Remaining uncertainty: Different endpoints under the same bibliography are not independent replication; unique counts remain null.
- 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: S02

### N03 · How are matching review identifiers, different titles and included trials linked?

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 review title is Effects of ginger supplementation on cardiometabolic risk factors in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Bibliographic PMID42337792, PMC13495174 and DOI10.1186/s13643-026-03251-5 match the other endpoint record, while the study title/bibliographic author display differ. The sample wording is 13 papers.
- Why unverified: Matching retained identifiers and different titles were linked as recorded. Without an included-trial table, endpoint contribution and overlap with the direct trial could not be compared.
- Reason for missing information: Exact review-title/author identity, included trials, endpoint subsets and unique participants are unverified.
- Required materials and conditions: Review PMID/PMC/DOI, record-specific bibliographic/title literals, included-trial table and endpoint contribution/overlap
- Materials to obtain first: Review PMID/PMC/DOI, record-specific bibliographic/title literals, included-trial table and endpoint contribution/overlap
- Further research: Material needed: Review PMID/PMC/DOI, record-specific bibliographic/title literals, included-trial table and endpoint contribution/overlap. This records needed materials; no new research was executed.
- Conditions for verification: Retain the verification level for matching identifiers and different titles, distinguishing paper counts from unique-trial counts.
- Why this condition is needed: Needed to avoid converting the same review into independent replication or exact bibliographic certification
- Application exceptions: Do not harmonize record-specific study-title literals merely because bibliographic identifiers match. A missing included-trial table does not establish no overlap.
- Remaining uncertainty: 13 papers do not mean 13 unique trials or replication of the same formulation. Separate bibliographic corrections: 0.
- 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: S01

### N04 · Which retained summaries and external originals were actually read?

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 this work covers the complete retained original and its research/bibliographic summaries. External PubMed/abstracts, PMC/publisher full texts and registration for its reports were neither read nor accessed. Original links are not reading records.
- Why unverified: This condition concerns disclosure of reading level. Actual reading of the full retained summary and unattempted/unread linked external materials were separately disclosed by material, meeting that disclosure scope. External-original and clinical-content verification remain unverified.
- Reason for missing information: External full-text/abstract/registration/protocol/SAP files were not acquired or read; this is not inaccessibility.
- Required materials and conditions: Retained summaries, bibliography/abstracts, full texts, access attempts and acquisition/reading records by material type
- Materials to obtain first: Retained summaries, bibliography/abstracts, full texts, access attempts and acquisition/reading records by material type
- Further research: Material needed: Retained summaries, bibliography/abstracts, full texts, access attempts and acquisition/reading records by material type. This records needed materials; no new research was executed.
- Conditions for verification: Display actual reading of retained local summaries separately from unread external full texts/abstracts/registration and unattempted access.
- Why this condition is needed: Needed to avoid upgrading original links into full-text reading records
- Application exceptions: Acknowledge reading of retained summaries without labeling it full-text or registration reading. Unattempted external access is not inaccessibility.
- Remaining uncertainty: Historical verification/date and review wording are not backdated into successful external access in this work.
- 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: S02, S01

### N05 · Were registration, protocol and SAP actually acquired and compared?

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 direct-trial bibliography includes NCT02666807, while its original registration field says unverified. Protocol/SAP originals and registration version, time and page positions are not specified in the retained record and were not accessed in this work.
- Why unverified: A bibliographic string alone cannot meet registration/planning-content comparison or actual-acquisition requirements.
- Reason for missing information: External registration/protocol/SAP, versions, times and original locations remain unverified.
- Required materials and conditions: Bibliographic NCT string, original registration field, registration version/time and protocol/SAP originals
- Materials to obtain first: Bibliographic NCT string, original registration field, registration version/time and protocol/SAP originals
- Further research: Material needed: Bibliographic NCT string, original registration field, registration version/time and protocol/SAP originals. This records needed materials; no new research was executed.
- Conditions for verification: Distinguish historical registration narratives from the current level of retained bibliographic strings, leaving external comparison unverified.
- Why this condition is needed: Needed to avoid treating a registration identifier as verification of a prespecified plan
- Application exceptions: An NCT string does not establish completed acquisition/comparison of registration, protocol or SAP. Unacquired material is not described as nonregistration.
- Remaining uncertainty: Unacquired material does not establish nonregistration, no plan or confirmed selective reporting.
- 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: S02

### N06 · Who is the selected T2D population, including exclusions and baseline characteristics?

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 population is adults with type 2 diabetes who did not use insulin and maintained oral glucose-lowering medication. Nonuse of insulin is retained as written. Statin wording from the other LDL record is not inserted into this HbA1c population field.
- Why unverified: The selected T2D/concomitant-treatment scope is retained, but original recruitment and arm-specific baseline characteristics are unavailable.
- Reason for missing information: Age, diagnostic criteria, arm-specific baseline measures/exclusions and selection flow remain unverified.
- Required materials and conditions: Age/diagnosis, insulin/lipid medication, baseline HbA1c, eligibility and arm-specific characteristics of adults with type 2 diabetes not using insulin and maintaining oral glucose-lowering medication
- Materials to obtain first: Age/diagnosis, insulin/lipid medication, baseline HbA1c, eligibility and arm-specific characteristics of adults with type 2 diabetes not using insulin and maintaining oral glucose-lowering medication
- Further research: Material needed: Age/diagnosis, insulin/lipid medication, baseline HbA1c, eligibility and arm-specific characteristics of adults with type 2 diabetes not using insulin and maintaining oral glucose-lowering medication. This records needed materials; no new research was executed.
- Conditions for verification: Link only the stated population, preserving record-specific nonuse-of-insulin/statin limitations.
- Why this condition is needed: Needed to avoid extrapolating differences in study populations into efficacy for all adults
- Application exceptions: Retain record-specific insulin/statin wording differences. Matching T2D labels do not authorize importing baseline/exclusion criteria from another record.
- Remaining uncertainty: A population summary is not extended into efficacy for all adults or other medication groups.
- 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: S02

### N07 · What are the dried powder's composition, capsules and actual administered amount?

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 formulation is dried ginger-powder 500 mg capsules; gingerol/shogaol assay is unverified. Zingiber officinale Roscoe rhizome was taken orally at 1 g, 2 times daily, 2 g/day total. Nominal powder quantity remains distinct from gingerol/shogaol assay.
- Why unverified: Nominal formulation/dose appear in the current record, but active constituents, manufacturing/quality and actual adherence are unverified.
- Reason for missing information: Gingerol/shogaol assay, manufacturing/consistency and actual intake remain unverified.
- Required materials and conditions: Rhizome, 500 mg capsules, 2 g/day, dosing frequency, gingerol/shogaol assay and manufacturing/quality
- Materials to obtain first: Rhizome, 500 mg capsules, 2 g/day, dosing frequency, gingerol/shogaol assay and manufacturing/quality
- Further research: Material needed: Rhizome, 500 mg capsules, 2 g/day, dosing frequency, gingerol/shogaol assay and manufacturing/quality. This records needed materials; no new research was executed.
- Conditions for verification: Distinguish nominal powder amount from active-constituent assay/actual adherence without treating foods or extracts as automatically equivalent.
- Why this condition is needed: Needed to avoid applying a formulation or dose directly to other products
- Application exceptions: Nominal capsule powder quantity differs from gingerol/shogaol active-constituent assay. Unverified assay does not establish 0 active constituent or a defective product.
- Remaining uncertainty: There is no automatic equivalence with standardized extracts, foods, essential oils or combinations.
- 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: S02

### N08 · What actually differed between placebo and existing treatment in the arms?

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 comparator was wheat-flour placebo plus existing oral glucose-lowering medication, in adults with type 2 diabetes not using insulin and maintaining oral medication. This compares continued oral treatment; it does not ask about jointly reducing or replacing ginger and existing medication.
- Why unverified: Nominal shared treatment/wheat-flour placebo are present, but arm-specific medication types, changes and other-treatment differences are unavailable.
- Reason for missing information: Arm-specific glucose/lipid medication types, doses, changes and placebo details remain unverified.
- Required materials and conditions: Wheat-flour placebo, continued oral glucose-lowering medication, lipid-medication control and arm-specific concomitant treatment/changes
- Materials to obtain first: Wheat-flour placebo, continued oral glucose-lowering medication, lipid-medication control and arm-specific concomitant treatment/changes
- Further research: Material needed: Wheat-flour placebo, continued oral glucose-lowering medication, lipid-medication control and arm-specific concomitant treatment/changes. This records needed materials; no new research was executed.
- Conditions for verification: Separate shared existing care from added ginger and do not convert the comparison into statin-add-on or medication-replacement efficacy.
- Why this condition is needed: Needed to avoid attributing concomitant-treatment differences to powder alone
- Application exceptions: Shared continuation of existing medication differs from control of arm-specific changes. Inadequate lipid-medication control does not determine success/failure of statin add-on or statin replacement.
- Remaining uncertainty: The original comparison is not converted into statin-add-on efficacy or glucose-lowering-medication replacement evidence.
- 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: S02

### N09 · What is known about 10-week exposure, dosing schedule and post-treatment observation?

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 exposure contract is 10-week treatment, 1 g at each of 2 daily doses, 2 g/day total; the selected measure is absolute HbA1c change at 10 weeks. Visit-specific intake/adherence and post-treatment follow-up cannot be established from this summary.
- Why unverified: The nominal 10-week exposure/endpoint contract is linked, but actual exposure and the complete timeline are unverified.
- Reason for missing information: Visits, adherence, exposure loss and post-treatment follow-up remain unverified.
- Required materials and conditions: 10-week treatment, visits, exposure/adherence, post-treatment follow-up and time-specific results
- Materials to obtain first: 10-week treatment, visits, exposure/adherence, post-treatment follow-up and time-specific results
- Further research: Material needed: 10-week treatment, visits, exposure/adherence, post-treatment follow-up and time-specific results. This records needed materials; no new research was executed.
- Conditions for verification: Record the selected 10-week result separately from existence or uncertainty of withdrawal/long-term follow-up.
- Why this condition is needed: Needed to avoid extending short treatment data into sustained long-term effects
- Application exceptions: A 10-week treatment statement does not establish complete visits, actual adherence or post-treatment follow-up. Unverified long-term results do not erase the 10-week endpoint value.
- Remaining uncertainty: The 10-week endpoint change is not extended into post-treatment or long-term 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: S02

### N10 · Are the direct-trial HbA1c values final values, within-arm changes or between-arm differences?

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 direct trial reports HbA1c arm-specific changes of -0.38 versus +0.22 percentage points, P<.0001; the exact adjusted CI is unverified. Arm changes remain distinct from adjusted between-arm estimates, and no new effect was calculated by subtraction.
- Why unverified: The reported value format, units and timing are linked, but exact between-arm changes/adjusted estimates and CIs remain unverified.
- Reason for missing information: Original tables for exact change differences/adjusted between-arm effects, denominators and CIs remain unverified.
- Required materials and conditions: HbA1c result units, arm values/changes, adjusted between-arm estimate, comparison time and direction
- Materials to obtain first: HbA1c result units, arm values/changes, adjusted between-arm estimate, comparison time and direction
- Further research: Material needed: HbA1c result units, arm values/changes, adjusted between-arm estimate, comparison time and direction. This records needed materials; no new research was executed.
- Conditions for verification: Preserve the original HbA1c result format without newly calculating unreported differences or adjusted effects.
- Why this condition is needed: Needed to avoid transferring numerically different analysis formats as the same effect
- Application exceptions: Arm-specific final values or changes differ from adjusted between-arm effects. Do not subtract the values or derive exact change differences/CIs from the P value.
- Remaining uncertainty: Significance or differences between arm values are not transferred into another effect without verifying the reported estimation contract.
- 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: S02

### N11 · What does the review's pooled HbA1c estimate, CI and I² refer to?

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 synthesis reports MD -0.41 percentage points, 95% CI -0.63 to -0.20; I²=92.09%; 13 papers. These remain pooled absolute HbA1c changes in percentage points, without guaranteeing a 0.41 percentage-point reduction for a particular product or person.
- Why unverified: Endpoint-specific pooled values/reported intervals are retained, but details of contributing trials, formulation, medication and model directness remain unverified.
- Reason for missing information: Contributing subsets, trial-specific conditions/estimates, exact denominators, models and overlap tables remain unverified.
- Required materials and conditions: Endpoint-specific MD, units, CI, I², contributing trials/populations/formulations and analysis model
- Materials to obtain first: Endpoint-specific MD, units, CI, I², contributing trials/populations/formulations and analysis model
- Further research: Material needed: Endpoint-specific MD, units, CI, I², contributing trials/populations/formulations and analysis model. This records needed materials; no new research was executed.
- Conditions for verification: Attribute pooled values to their endpoint/question without using them as expected effects for a particular product or person.
- Why this condition is needed: Needed to avoid extending a review average into guaranteed effects for an identical product
- Application exceptions: The review's overall paper count is not its endpoint-specific contributing-trial count or same-product trial count. Do not turn a pooled estimate into direct-trial arm values or guaranteed personal effects.
- Remaining uncertainty: The review average does not replace the between-arm effect of the original 10-week, 2 g capsule product.
- 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: S01

### N12 · Is the table's selected endpoint the same as the registered primary (1st)/secondary (2nd) 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 selected page endpoint is absolute HbA1c change at 10 weeks. The retained direct report describes registered NF-κB primary (1st) and HbA1c secondary (2nd), explicitly retaining NF-κB primary (1st)/HbA1c secondary (2nd).
- Why unverified: The selected endpoint and historical registration hierarchy were distinguished, but actual planning originals were not compared.
- Reason for missing information: External comparison of original registration/protocol, article hierarchy and reasons for changes remains unverified.
- Required materials and conditions: The selected-endpoint field's role, the direct trial's registered endpoints, NF-κB and article/plan comparison
- Materials to obtain first: The selected-endpoint field's role, the direct trial's registered endpoints, NF-κB and article/plan comparison
- Further research: Material needed: The selected-endpoint field's role, the direct trial's registered endpoints, NF-κB and article/plan comparison. This records needed materials; no new research was executed.
- Conditions for verification: Do not promote the selected measure into the registered primary (1st) endpoint; retain the reported secondary (2nd) status and unperformed comparison.
- Why this condition is needed: Needed to avoid deriving original-trial primary (1st) success/failure from a field name alone
- Application exceptions: The selected-endpoint field is the table's selection key. Do not relabel registered secondary (2nd) status as co-primary (1st) or as an invalid primary (1st) trial.
- Remaining uncertainty: The selected-endpoint field name does not certify the registered primary (1st) endpoint.
- 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: S02

### N13 · What are the randomized, analyzed and completed denominators and the arm mapping of 23/22?

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 direct-trial denominators are 50 randomized and 45 analyzed (23/22). Randomized 50/analyzed 45 remain distinct; the summary does not state ginger/placebo mapping of 23/22 or completion. Matching values in another endpoint table are not summed.
- Why unverified: Randomized/analyzed literals are verified, but arm/endpoint denominator roles remain incomplete.
- Reason for missing information: Arm mapping, endpoint-specific analysis/completion and shared-participant details remain unverified.
- Required materials and conditions: 50 randomized, 45 analyzed, arm/endpoint denominators, arm mapping and completion/flow diagram
- Materials to obtain first: 50 randomized, 45 analyzed, arm/endpoint denominators, arm mapping and completion/flow diagram
- Further research: Material needed: 50 randomized, 45 analyzed, arm/endpoint denominators, arm mapping and completion/flow diagram. This records needed materials; no new research was executed.
- Conditions for verification: Distinguish each reported denominator without inferring ginger/placebo mapping or completion from 23/22.
- Why this condition is needed: Needed to avoid duplication or misattribution of denominator roles and shared participants
- Application exceptions: Distinguish 50 randomized from 45 analyzed. Do not infer the ginger/placebo order of 23/22 or the completion denominator when unstated.
- Remaining uncertainty: Do not create new denominators from rounding, generic English sample wording or counts of mentions.
- 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: S02

### N14 · Were missingness, dropout reasons and ITT/PP handling verified?

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 direct summary gives 50 randomized and 45 analyzed (23/22), without specific missingness/dropout reasons, analysis exclusion/imputation or ITT/PP. No new dropout/completion count was calculated by subtracting analyzed from randomized participants.
- Why unverified: Denominator summaries cannot establish missing-data handling or the estimand, and external flow diagrams were not read.
- Reason for missing information: Arm-specific missingness, dropout/discontinuation, exclusion/imputation and ITT/PP remain unverified.
- Required materials and conditions: Participant flow, arm-specific missingness/dropout, analysis exclusion and ITT/PP/imputation
- Materials to obtain first: Participant flow, arm-specific missingness/dropout, analysis exclusion and ITT/PP/imputation
- Further research: Material needed: Participant flow, arm-specific missingness/dropout, analysis exclusion and ITT/PP/imputation. This records needed materials; no new research was executed.
- Conditions for verification: Report the distinction between randomized and analyzed participants without calculating dropout/completion or naming the analysis method.
- Why this condition is needed: Needed to avoid treating analyzed participant counts as proof of no missingness
- Application exceptions: Do not calculate the randomized/analyzed difference as a dropout/discontinuation count. Missing handling information does not establish ITT, PP or no missingness.
- Remaining uncertainty: Unverified information does not establish no missingness or definite analysis 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: S02

### N15 · Are the direct trial's SD, SE, CI and exact between-arm estimates distinguished?

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: Only the original HbA1c arm changes and P<.0001 are retained; exact adjusted CIs/arm-change variances are unverified. Significance did not substitute for exact precision.
- Why unverified: Some original values exist, but the requested exact between-arm estimates and precision contract remain unverified.
- Reason for missing information: SD/SE definitions, original variance/denominators and exact change/adjusted-effect CIs remain unverified.
- Required materials and conditions: HbA1c original tables, variance definitions, exact change differences/adjusted effects, CIs and arm denominators
- Materials to obtain first: HbA1c original tables, variance definitions, exact change differences/adjusted effects, CIs and arm denominators
- Further research: Material needed: HbA1c original tables, variance definitions, exact change differences/adjusted effects, CIs and arm denominators. This records needed materials; no new research was executed.
- Conditions for verification: Separate reported values from unverified precision without calculating missing CIs or variance definitions.
- Why this condition is needed: Needed to avoid establishing effect precision from P values or sample sizes alone
- Application exceptions: Retain the original ± notation if SD/SE definitions are unavailable. Missing CIs do not justify an arbitrary precision score or effect 0.
- Remaining uncertainty: Do not infer absent variance/CIs or convert them into a new score.
- 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: S02

### N16 · Were favorable, null and contrary endpoint results kept within their original questions?

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 positive pooled HbA1c report and direct arm changes are retained alongside the original warnings about formulation, dose, existing medication and large heterogeneity. FBG, insulin, HOMA-IR, weight and lipids are not converted into HbA1c effects.
- Why unverified: Favorable/counterargument narratives and result formats are linked, but the full distribution of contrary/null trial results is unavailable.
- Reason for missing information: Trial-level result distributions, older review/direct original tables and endpoint comparisons remain unverified.
- Required materials and conditions: Direct/pooled endpoint results, original counterarguments and other-endpoint scope
- Materials to obtain first: Direct/pooled endpoint results, original counterarguments and other-endpoint scope
- Further research: Material needed: Direct/pooled endpoint results, original counterarguments and other-endpoint scope. This records needed materials; no new research was executed.
- Conditions for verification: Retain related positive, nonsignificant and differing results without substituting other endpoints for the selected endpoint's efficacy.
- Why this condition is needed: Needed to avoid erasing material gaps by selecting favorable results
- Application exceptions: Preserve counterarguments from other endpoints/analyses as relevant context. Their values do not erase uncertainty in the selected endpoint.
- Remaining uncertainty: Do not select only favorable narratives or use positives on other endpoints to erase heterogeneity/precision gaps.
- 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: S02, S01

### N17 · How are nonsignificance, heterogeneity and decimal differences interpreted?

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: Narrative HbA1c I²92% and detailed 92.09% are each retained literally. The reported MD -0.41 percentage points/CI -0.63 to -0.20 is distinguished from high heterogeneity; rounding alone does not trigger a data-conflict status.
- Why unverified: Statistical/rounding literals are retained, but original-material assessment of imprecision and between-study differences was not performed.
- Reason for missing information: Causes of high heterogeneity, original decimals/models, equivalence plans and trial estimates remain unverified.
- Required materials and conditions: Reported P values, inclusion of 0, CIs, rounded I² and different analysis conditions
- Materials to obtain first: Reported P values, inclusion of 0, CIs, rounded I² and different analysis conditions
- Further research: Material needed: Reported P values, inclusion of 0, CIs, rounded I² and different analysis conditions. This records needed materials; no new research was executed.
- Conditions for verification: Do not convert nonsignificance into effect 0/equivalence or automatically label rounding/different-analysis values as data conflicts.
- Why this condition is needed: Needed to avoid conflating different limitations with the same failure or conflict
- Application exceptions: Nonsignificance does not prove equivalence/effect 0. Rounded I² and different review estimates require comparison of endpoint/analysis contracts before judging conflict.
- Remaining uncertainty: High I² does not itself mean effect 0 or failure of the registered plan.
- 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: S02, S01

### N18 · What are the limits of historical search/review narratives and currently acquired reports?

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 record describes a T2D RCT meta-analysis and comparison with a registration-checked 2 g/day, 10-week trial. Acquired material consists of the 2 retained report summaries/bibliographies; search sources/strategies, selection flow and original registration files were not acquired in this work.
- Why unverified: Historical narratives were separated from current retained-material reading. Without original-material details, neither a current exhaustive search nor absence of articles can be certified.
- Reason for missing information: Historical search records, review bibliography and selection/included-trial details remain unverified.
- Required materials and conditions: Current research/bibliographic summaries 2, historical year/trial-count narratives, search sources/strategies, selection and included-study tables
- Materials to obtain first: Current research/bibliographic summaries 2, historical year/trial-count narratives, search sources/strategies, selection and included-study tables
- Further research: Material needed: Current research/bibliographic summaries 2, historical year/trial-count narratives, search sources/strategies, selection and included-study tables. This records needed materials; no new research was executed.
- Conditions for verification: Retain historical search/review narratives while separating missing current source locations from the absence of a new search.
- Why this condition is needed: Needed to avoid conflating absence of literature with work not performed
- Application exceptions: Historical claims of reviewing studies do not record new original acquisition beyond the current 2 reports. An unperformed search does not mean 0 human studies.
- Remaining uncertainty: An unperformed search is not described as 0 studies or absence of all 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: S02, S01

### N19 · How are the original verdict date, correction date and actual current reading date distinguished?

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; the correction is the English correction record of 2026-09-14. The current date concerns retained-summary conversion review, not external full-text verification or a new evidence cutoff.
- Why unverified: Historical record dates and the current work date were retained with separate roles, without converting dates into successful new clinical searches.
- Reason for missing information: The original evidence-cutoff field and historical search date/external access level, location and date are unverified in this input.
- Required materials and conditions: Original verification date, correction date, current conversion-review date, input hashes and revision links
- Materials to obtain first: Original verification date, correction date, current conversion-review date, input hashes and revision links
- Further research: Material needed: Original verification date, correction date, current conversion-review date, input hashes and revision links. This records needed materials; no new research was executed.
- Conditions for verification: Do not reuse historical dates as current external full-text reading dates; state the scope of retained-material review.
- Why this condition is needed: Needed to avoid presenting historical verification as a new current-literature review
- Application exceptions: Original verification/correction dates are historical values. The current date is retained-material conversion review, without issuing a new evidence cutoff/external-reading date.
- Remaining uncertainty: Do not automatically fill an unverified cutoff with the original verdict date.
- 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: S02, S01

### N20 · What does university support and capsule purchasing establish about direct-trial independence?

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: Direct-trial funding is reported as TUMS 28653 university support and capsule purchasing. These are retained; product provision, employee authors, patents, declared COI and unique-team independence were not compared against external originals.
- Why unverified: Original funding is reported, but other components of independence remain unverified.
- Reason for missing information: Product support, author employment, patents, COI originals and institution/team links remain unverified.
- Required materials and conditions: TUMS28653 support, product purchasing/provision, employee authors, patents, declared COI and institutions/teams
- Materials to obtain first: TUMS28653 support, product purchasing/provision, employee authors, patents, declared COI and institutions/teams
- Further research: Material needed: TUMS28653 support, product purchasing/provision, employee authors, patents, declared COI and institutions/teams. This records needed materials; no new research was executed.
- Conditions for verification: Retain reported funding without using unverified product/authorship/conflict details as proof of independent replication or no bias.
- Why this condition is needed: Needed to avoid establishing overall independence from a single funding item
- Application exceptions: University funding and capsule purchasing differ from product provision, employment, patents and COI. Do not inherit the historical independence axis as certification of independent replication.
- Remaining uncertainty: The original independent-funding strength/I2 axis does not certify new independent clinical validation.
- 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: S02

### N21 · How do review funding and author COI differ from included-trial independence?

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: Review funding wording reports author declarations of no conflicts and mixed funding among original trials. Review declarations/funding remain distinct from contributing trials' mixed funding, products and institutions.
- Why unverified: Limited declarations in the review record are retained, but contributing-trial funding/independence were not compared.
- Reason for missing information: Original review funding/COI declarations, included-trial funding/products, institutions/teams and overlap remain unverified.
- Required materials and conditions: Review funding/COI, funding of each included trial, research teams/products and overlap
- Materials to obtain first: Review funding/COI, funding of each included trial, research teams/products and overlap
- Further research: Material needed: Review funding/COI, funding of each included trial, research teams/products and overlap. This records needed materials; no new research was executed.
- Conditions for verification: Separate review declarations from mixed original-trial funding without certifying papers as unique independent teams.
- Why this condition is needed: Needed to avoid transferring review support into independence of all contributing trials
- Application exceptions: Review COI/funding and included-trial funding are considered separately. A no-conflict declaration alone does not establish absence of product/included-trial bias.
- Remaining uncertainty: No-conflict/public-university-support summaries are not transferred into absence of bias across included 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: S01

### N22 · Were allocation, concealment and baseline balance verified beyond the randomized/double-blind label?

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 direct-trial design label is a randomized double-blind placebo trial. This summary does not establish sequence generation, allocation concealment, baseline balance or detailed parallel/crossover/cluster structure.
- Why unverified: Original RCT/blinding labels exist, but actual methodological information was not compared.
- Reason for missing information: Original allocation/concealment, baseline tables, design details and blinding methods remain unverified.
- Required materials and conditions: Parallel/crossover/cluster design, random sequence, concealment, baseline tables and blinding
- Materials to obtain first: Parallel/crossover/cluster design, random sequence, concealment, baseline tables and blinding
- Further research: Material needed: Parallel/crossover/cluster design, random sequence, concealment, baseline tables and blinding. This records needed materials; no new research was executed.
- Conditions for verification: Separate the RCT label from unverified details; do not arbitrarily mark crossover/cluster considerations not applicable when the design is unverified.
- Why this condition is needed: Needed to avoid treating a design label as resolution of allocation and confounding problems
- Application exceptions: The randomized/double-blind label does not verify sequence, concealment or baseline balance. Unverified design does not automatically make crossover/cluster considerations not applicable.
- Remaining uncertainty: The blinding label does not establish no problems or a completed formal RoB2 assessment.
- 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: S02

### N23 · Could concomitant medication, adherence, rescue care and arm-specific changes affect the estimate?

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 comparison with continued oral glucose-lowering medication concerns adults with type 2 diabetes who did not use insulin and maintained oral medication, versus wheat-flour placebo plus existing oral medication. Details of arm-specific medication changes, adherence, diet/activity, rescue care and analysis handling are not recorded.
- Why unverified: The nominal shared-treatment scope exists, but actual changes/deviations/estimand comparison for E02 lacks material.
- Reason for missing information: Medication types/doses/changes, actual adherence, diet/activity and rescue-treatment handling remain unverified.
- Required materials and conditions: Glucose/lipid medication types, arm changes, diet/activity, adherence, rescue care and estimand
- Materials to obtain first: Glucose/lipid medication types, arm changes, diet/activity, adherence, rescue care and estimand
- Further research: Material needed: Glucose/lipid medication types, arm changes, diet/activity, adherence, rescue care and estimand. This records needed materials; no new research was executed.
- Conditions for verification: Distinguish a continuation-of-medication statement from unverified arm-specific changes and adherence.
- Why this condition is needed: Needed to avoid attributing changes in other treatments to added ginger
- Application exceptions: Continuation of existing oral medication does not establish identical arm changes, adherence, diet or rescue care. Do not require that all changes must be identical.
- Remaining uncertainty: Unverified changes do not establish fully controlled identical care or an isolated ginger 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: S02

### N24 · How, when and under what blinding was HbA1c measured?

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 selected measure is absolute HbA1c change at 10 weeks, with arm-specific HbA1c changes in percentage points. Assay, sampling/visit times, baseline values and assessor-blinding details are absent from the current summary.
- Why unverified: The endpoint name/nominal time exist, but the measurement method and arm-specific error procedures remain unverified.
- Reason for missing information: Assay/sampling/baseline, 10-week visits, measurement error and assessor blinding remain unverified.
- Required materials and conditions: HbA1c assay/units, sampling conditions, baseline/10-week visits, measurement error and assessor blinding
- Materials to obtain first: HbA1c assay/units, sampling conditions, baseline/10-week visits, measurement error and assessor blinding
- Further research: Material needed: HbA1c assay/units, sampling conditions, baseline/10-week visits, measurement error and assessor blinding. This records needed materials; no new research was executed.
- Conditions for verification: Separate the nominal endpoint/units from unverified assay details.
- Why this condition is needed: Needed to avoid conflating measurement differences with actual outcome differences
- Application exceptions: An endpoint name and units do not verify the assay, sampling/visit times or assessor blinding. Even an objective assay requires separate assessment of measurement limitations.
- Remaining uncertainty: Do not fill measurement details from another endpoint's trial or generic legacy English wording.
- 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: S02

### N25 · What is the direct trial's estimand and analysis model?

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 selected contract is absolute HbA1c change at 10 weeks; the direct summary reports arm changes and P. Exact adjusted effects/CIs, analysis populations/models and ITT/PP remain unverified.
- Why unverified: Knowing the result format does not complete the effect definition without comparison of the estimand and original model.
- Reason for missing information: Assignment/adherence effects, analysis populations, covariates and original models remain unverified.
- Required materials and conditions: Assignment/adherence effects, covariates, ITT/PP, within/between-arm analysis, change/final values and model
- Materials to obtain first: Assignment/adherence effects, covariates, ITT/PP, within/between-arm analysis, change/final values and model
- Further research: Material needed: Assignment/adherence effects, covariates, ITT/PP, within/between-arm analysis, change/final values and model. This records needed materials; no new research was executed.
- Conditions for verification: Explain only the reported result format; absent analysis methods are not filled with adjusted estimates or ITT.
- Why this condition is needed: Needed to distinguish arm-specific values from the actual analysis estimand
- Application exceptions: Classify only the reported final/change format. If the estimand is unverified, do not assign assignment/adherence effects or ITT/PP.
- Remaining uncertainty: Do not infer adjusted estimates or assignment effects without material.
- 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: S02

### N26 · Can the CI be interpreted alongside a justified important difference?

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 synthesis provides an interval: MD -0.41 percentage points, 95% CI -0.63 to -0.20; I²=92.09%, but the direct trial's exact CI is unverified. The record supplies no justified important-difference threshold for the selected population/endpoint.
- Why unverified: The scope of reported intervals was read, but direct precision and clinical-importance comparison remain unverified.
- Reason for missing information: Direct CIs, justified important differences and interpretive material remain unverified.
- Required materials and conditions: Direct/pooled CIs, endpoint-specific variance, justified clinically important difference and interpretation contract
- Materials to obtain first: Direct/pooled CIs, endpoint-specific variance, justified clinically important difference and interpretation contract
- Further research: Material needed: Direct/pooled CIs, endpoint-specific variance, justified clinically important difference and interpretation contract. This records needed materials; no new research was executed.
- Conditions for verification: Retain the scope of reported intervals and unverified importance criteria; do not judge sufficiency using arbitrary minimum samples, duration or differences.
- Why this condition is needed: Needed to avoid upgrading statistical signals into clinical importance or a new grade
- Application exceptions: P values, sample sizes or review paper counts alone do not establish sufficient precision or clinical importance. Do not adopt arbitrary minimum participant, duration or difference thresholds.
- Remaining uncertainty: Do not create arbitrary minimum N, durations, important differences, fulfillment rates or new efficacy grades.
- 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: S02, S01

### N27 · Was the prespecified endpoint, timing and analysis compared with actual reporting?

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 describes registered NF-κB primary (1st) and HbA1c secondary (2nd) in the direct trial; external registration/SAP/protocol were not compared with actual endpoint, timing or analysis changes in this work.
- Why unverified: Historical registration hierarchy alone cannot certify agreement between prespecified plans and reporting.
- Reason for missing information: Registration versions/endpoints, analyses/timing, change reasons and SAP remain uncompared.
- Required materials and conditions: Original registration versions, protocol, SAP, article tables/change reasons and endpoint-specific plans
- Materials to obtain first: Original registration versions, protocol, SAP, article tables/change reasons and endpoint-specific plans
- Further research: Material needed: Original registration versions, protocol, SAP, article tables/change reasons and endpoint-specific plans. This records needed materials; no new research was executed.
- Conditions for verification: Retain reported secondary (2nd) status and unperformed comparison without converting unavailable plans into confirmed nonregistration/selective reporting.
- Why this condition is needed: Needed to expose missing material for assessing selection of favorable analyses
- Application exceptions: Separate historical registration-endpoint narratives from actual planning comparison in this work. Unacquired plans do not establish confirmed selective reporting.
- Remaining uncertainty: Unperformed comparison establishes neither nonregistration/confirmed selective reporting nor absence of planning problems.
- 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: S02

### N28 · Was the result replicated in independent families with the same formulation, dose and population?

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 notes formulation/dose/existing-medication differences, high heterogeneity and limited same-formulation replication. Included-trial/family-specific conditions and results for the representative 500 mg powder, 2 g/day, 10-week direct trial and mixed review were not acquired.
- Why unverified: A review count does not establish unique independent same-formulation replication for the selected contract.
- Reason for missing information: Included trials/overlap, family-specific formulations/medication, populations/doses/duration and result distributions remain unverified.
- Required materials and conditions: Trial/family-specific formulation, dose, duration, population, concomitant medication, result distributions and overlap
- Materials to obtain first: Trial/family-specific formulation, dose, duration, population, concomitant medication, result distributions and overlap
- Further research: Material needed: Trial/family-specific formulation, dose, duration, population, concomitant medication, result distributions and overlap. This records needed materials; no new research was executed.
- Conditions for verification: Do not label the representative trial and mixed review as independent replication of an identical formulation; retain condition differences and unverified direct replication.
- Why this condition is needed: Needed to avoid converting review paper counts/averages into same-product replication
- Application exceptions: Do not assume that the representative direct trial is included in the review and add it as new independent replication. A mixed-formulation/population review does not certify replication of the same 500 mg capsules at 2 g/day.
- Remaining uncertainty: Do not add the representative report and review into 14 independent trials or same-product reproducibility.
- 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: S02, S01

### N29 · Can direct comparisons of doses/products identify an optimal amount?

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 selected trial's nominal powder amount is 2 g/day; the retained summary has no direct superiority/optimal-dose comparison with other doses/products. Gingerol/shogaol assay is also unverified.
- Why unverified: A placebo comparison at a single dose and a mixed review do not answer direct dose/product comparisons.
- Reason for missing information: Direct dose-response/product comparisons, active-constituent assay and interaction estimates remain unverified.
- Required materials and conditions: Direct dose/product comparison, active-constituent assay, dose response/interactions and independent estimates
- Materials to obtain first: Direct dose/product comparison, active-constituent assay, dose response/interactions and independent estimates
- Further research: Material needed: Direct dose/product comparison, active-constituent assay, dose response/interactions and independent estimates. This records needed materials; no new research was executed.
- Conditions for verification: Do not call the selected 2 g/day optimal or equivalent to other products. Missing direct comparison does not erase the narrow 10-week result.
- Why this condition is needed: Needed to avoid extending a trial dose into an individual's optimal intake
- Application exceptions: A trial's 2 g/day does not establish optimal dosage or equivalent-product efficacy. Unverified direct dose comparisons do not automatically suspend the narrow question.
- Remaining uncertainty: 2 g/day does not establish personal dosing instructions, an optimal dose or equivalent efficacy of other products.
- 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: S02

### N30 · Were persistence after withdrawal and results beyond 10 weeks verified?

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 selected duration is 10 weeks of treatment. Separate reports and denominators for post-treatment persistence or long-term results beyond 10 weeks are unverified in the retained summary.
- Why unverified: 10-week material alone does not answer post-treatment or long-term-follow-up questions.
- Reason for missing information: Post-treatment/long-term visits, time-specific between-arm estimates and denominators remain unverified.
- Required materials and conditions: Follow-up beyond 10 weeks/after withdrawal, repeated measurements, time-specific results and separate comparisons
- Materials to obtain first: Follow-up beyond 10 weeks/after withdrawal, repeated measurements, time-specific results and separate comparisons
- Further research: Material needed: Follow-up beyond 10 weeks/after withdrawal, repeated measurements, time-specific results and separate comparisons. This records needed materials; no new research was executed.
- Conditions for verification: Separate 10-week material from long-term persistence questions and retain unverified long-term evidence.
- Why this condition is needed: Needed to avoid extending short-term values into long-term maintenance or suppressed progression
- Application exceptions: Short-term endpoints and post-treatment persistence/long-term results are separate questions. Unverified long-term material does not establish no long-term effect.
- Remaining uncertainty: Unverified long-term material means neither no long-term effect nor a reason to erase original 10-week values.
- 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: S02, S01

### N31 · Were baseline, medication and special-population subgroup effects separately verified?

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 selected population is adults with type 2 diabetes not using insulin and maintaining oral glucose-lowering medication. Prespecified baseline/medication subgroups, interactions and separate denominators/estimates for insulin, older adults, kidney disease or complex concomitant treatment are absent from the retained summary.
- Why unverified: A population name alone cannot establish special-population or individual differences in response.
- Reason for missing information: Prespecified subgroups, interactions, denominators/estimates and concomitant-treatment material remain unverified.
- Required materials and conditions: Prespecified subgroups, interactions, baseline measures/medication/insulin, and separate denominators/estimates in older adults or kidney disease
- Materials to obtain first: Prespecified subgroups, interactions, baseline measures/medication/insulin, and separate denominators/estimates in older adults or kidney disease
- Further research: Material needed: Prespecified subgroups, interactions, baseline measures/medication/insulin, and separate denominators/estimates in older adults or kidney disease. This records needed materials; no new research was executed.
- Conditions for verification: Do not apply nominal T2D results to all populations; preserve the original population wording and unverified subgroup questions.
- Why this condition is needed: Needed to avoid extending a selected-population main effect into special-population efficacy
- Application exceptions: Subgroup estimates require prespecification, interaction assessment and arm-specific denominators. Do not infer insulin, older-adult, kidney-disease or complex-medication information from a small-sample main effect.
- Remaining uncertainty: Separate unverified subgroups from the overall selected T2D question without creating unsupported efficacy.
- 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: S02, S01

### N32 · Does HbA1c change answer clinical-event or medication-replacement questions?

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 advertising boundary states that stopping glucose-lowering medication, diabetes remission or a particular product lowering everyone by 0.41 percentage points exceeds the evidence. The retained scope judges HbA1c alone, keeping fasting glucose, HOMA-IR, weight and lipids separate. Direct event/complication, remission, quality-of-life and medication-reduction material was not verified in this summary.
- Why unverified: The boundary between the selected endpoint and clinical/medication questions is stated, but separate direct clinical outcomes remain unverified.
- Reason for missing information: Separate direct results for cardiovascular events, complications, remission and medication reduction remain unverified.
- Required materials and conditions: Distinguish endpoint changes from cardiovascular events, diabetes complications/remission, quality of life and medication reduction
- Materials to obtain first: Distinguish endpoint changes from cardiovascular events, diabetes complications/remission, quality of life and medication reduction
- Further research: Material needed: Distinguish endpoint changes from cardiovascular events, diabetes complications/remission, quality of life and medication reduction. This records needed materials; no new research was executed.
- Conditions for verification: Do not transfer a narrow endpoint result into event prevention, remission or medication replacement. Do not make event trials mandatory for the endpoint result.
- Why this condition is needed: Needed to avoid combining surrogate measures and patient clinical outcomes into the same claim
- Application exceptions: Retain the numerical-endpoint comparison itself. Do not automatically substitute endpoint values for events/complications/remission or medication discontinuation, or require event trials as a prerequisite for endpoint values.
- Remaining uncertainty: Endpoint signals do not support medication replacement/stopping treatment, and event evidence is not forced as a prerequisite for endpoint values.
- 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: S02, S01

### N33 · What is known about actual adverse events, withdrawal and denominators for the same exposure?

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 label is Caution. Its detailed guidance notes possible hypoglycemia with glucose-lowering medication, no arbitrary medication reduction, gastrointestinal discomfort and interactions. Actual arm-specific harm counts/denominators, collection methods/duration and withdrawals in both reports remain unverified in the summary.
- Why unverified: General caution wording exists, but actual adverse-event collection for the selected exposure is not established.
- Reason for missing information: Harm definitions, arm-specific events, denominators/duration, withdrawal, collection and missingness remain unverified.
- Required materials and conditions: Arm-specific harms, definitions/collection, denominators/duration, withdrawal and separation from efficacy denominators
- Materials to obtain first: Arm-specific harms, definitions/collection, denominators/duration, withdrawal and separation from efficacy denominators
- Further research: Material needed: Arm-specific harms, definitions/collection, denominators/duration, withdrawal and separation from efficacy denominators. This records needed materials; no new research was executed.
- Conditions for verification: Separate existing caution wording from actual harm counts; unverified information is not safety or absence of events.
- Why this condition is needed: Needed to avoid treating available efficacy material as verified safety
- Application exceptions: Caution wording differs from actual adverse-event collection. Do not reuse efficacy denominators for harm incidence or fill missing event/withdrawal counts with 0.
- Remaining uncertainty: Do not substitute efficacy 50/45 as harm denominators or display no events/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: S02, S01

### N34 · What is known about medication interactions, rare/long-term harms and special populations?

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: Retain cautions about possible hypoglycemia with glucose-lowering medication, no arbitrary medication reduction, gastrointestinal discomfort and interactions. Actual arm-specific hypoglycemia, causal-interaction frequency and long-term/vulnerable-population harms remain unverified.
- Why unverified: Possibility-based guidance differs from established arm-specific events or interaction risks.
- Reason for missing information: Drug-specific, long-term/rare/vulnerable-population harms, onset/recovery and independent event material remain unverified.
- Required materials and conditions: Original hypoglycemia/gastrointestinal, anticoagulant/antiplatelet, concomitant-treatment, long-term/vulnerable-population harm material
- Materials to obtain first: Original hypoglycemia/gastrointestinal, anticoagulant/antiplatelet, concomitant-treatment, long-term/vulnerable-population harm material
- Further research: Material needed: Original hypoglycemia/gastrointestinal, anticoagulant/antiplatelet, concomitant-treatment, long-term/vulnerable-population harm material. This records needed materials; no new research was executed.
- Conditions for verification: Retain only the original caution level without certifying causal interactions, incidence or long-term safety.
- Why this condition is needed: Needed to separate general cautions from actually observed harms
- Application exceptions: Do not display possible-interaction cautions as observed causal interactions. Do not extend 10-week efficacy material into certification of rare/long-term harms or vulnerable-population safety.
- Remaining uncertainty: Do not inherit the caution label as a new safety assessment, causal conclusion or personal medication-change instruction.
- 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: S02, S01

### N35 · How are actual generic English wording and historical English corrections 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 2026-09-14 correction says that 2 generic English evidence-table fields were replaced with specific English. However, both reports' English sample, funding, endpoint, result and weighting fields still contain generic sentences in the current original. Both originals were preserved.
- Why unverified: This condition concerns preservation of current English literals and historical correction reports. Residual generic English and the full 2026-09-14 correction are preserved without inferring specific English or a new translation, meeting that preservation scope. Historical corrected versions, field correspondence and omission details remain unverified.
- Reason for missing information: The actual historical English correction version, field correspondence and a separate translation-correction event remain unverified.
- Required materials and conditions: Specific Korean results, generic English fields, full correction originals, currently selected original and authority for translation changes
- Materials to obtain first: Specific Korean results, generic English fields, full correction originals, currently selected original and authority for translation changes
- Further research: Material needed: Specific Korean results, generic English fields, full correction originals, currently selected original and authority for translation changes. This records needed materials; no new research was executed.
- Conditions for verification: Retain both current English literals and historical correction reports without inferring specific English exists or performing a correction of the original translation in this work.
- Why this condition is needed: Needed to avoid conflating a reported correction with actual current content
- Application exceptions: A correction record does not prove current specific English exists. Retain specific Korean values and generic English wording separately; translation/criteria correction requires a separate authorized event.
- Remaining uncertainty: Generic English does not independently validate specific Korean numbers; no new English numbers are written into the original.
- 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: S02, S01

### N36 · How is the bibliographic NCT string distinguished from the unverified original registration field?

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: Direct bibliographic NCT02666807, unverified direct-trial registration and unverified review registration are each retained. A registration entrance built from a bibliographic string is not a link whose current response/original identity was verified.
- Why unverified: Different verification levels of original fields are retained, but registration-content comparison/field correction was not performed.
- Reason for missing information: External comparison of registration identity/contents, versions, endpoints and times remains unverified.
- Required materials and conditions: Direct bibliographic NCT, original registration value, external registration identity/version and comparison history
- Materials to obtain first: Direct bibliographic NCT, original registration value, external registration identity/version and comparison history
- Further research: Material needed: Direct bibliographic NCT, original registration value, external registration identity/version and comparison history. This records needed materials; no new research was executed.
- Conditions for verification: Separate string existence from registration-content verification without arbitrarily harmonizing the original registration field.
- Why this condition is needed: Needed to preserve different states for exact bibliographic links and planning comparison
- Application exceptions: An unverified original registration field and a bibliographic NCT string are different verification levels. Do not replace them with a convenient single value or add a completed-registration-reading badge.
- Remaining uncertainty: Do not replace the registration field with the bibliographic ID or describe unverified information as nonregistration.
- 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: S02, S01

### N37 · Were the existing C50, all axes, original dates/URLs and historical review labels retained?

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 current original C50, Caution, all axes, final Korean/English values, dates/corrections, URLs, empty subclaims and blank deliberation were retained exactly in the preserved original. Its Codex independent-cross-check wording is a historical label, not current clinical validation.
- Why unverified: Original-byte preservation and the distinction between historical values and current condition status were directly checked. C50 did not automatically upgrade condition statuses.
- Reason for missing information: No original-text/score change in this work. External independent clinical review or formal-assessment certification was not performed.
- Required materials and conditions: Grade/score/safety, boolean/empty axis values, Korean/English historical values, corrections, URL and original verification date
- Materials to obtain first: Grade/score/safety, boolean/empty axis values, Korean/English historical values, corrections, URL and original verification date
- Further research: Material needed: Grade/score/safety, boolean/empty axis values, Korean/English historical values, corrections, URL and original verification date. This records needed materials; no new research was executed.
- Conditions for verification: Preserve the whole original exactly without inheriting historical scores, axes or verification wording as current condition status, new conclusions or clinical certification.
- Why this condition is needed: Needed to distinguish preservation of the original verdict from current gap-map statuses
- Application exceptions: Retain the existing grade/score, false/blank axis values, original URLs and dates. Do not display historical Codex independent cross-checks as current independent clinical validation.
- Remaining uncertainty: Source-hash checks do not establish clinical truth or independent expert validation.
- 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: S02, S01

## Evidence and sources

### S01

Effects of ginger supplementation on cardiometabolic risk factors in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

[PubMed](https://pubmed.ncbi.nlm.nih.gov/42337792/)

Materials actually read: 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.  
Findings recorded in the summary: MD −0.41%p, 95% CI −0.63~−0.20; I²=92.09%  
Record level: These are retained pooled HbA1c estimates. Narrative I² 92% and detailed 92.09% are each retained without a new conflict judgment.  
Independent replication: The direct report's 50 randomized and 45 analyzed participants (23/22) are shared with another endpoint in record 3052 and are not added together. The 13 papers are not a unique-trial count. Included trials, overlap and unique participant counts in the synthesis are unverified.

| Material | Public availability | Access status | Actually read | Notes |
|---|---|---|---|---|
| Retained research/bibliographic summary | Existence verified in retained input | Local input read | Retained existing review summary read | The retained research/bibliographic summary was actually read; this is not full-text reading. Different titles/author displays under the same bibliographic identifiers were preserved. Included trials, contributing subsets, variance, denominators and models remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Bibliography/abstract | Bibliographic identifier/entrance retained; actual availability/response unverified | External access not attempted; not acquired | False | Only URLs/identifiers were retained. Current external responses, files, identity and contents are unverified. Different titles/author displays under the same bibliographic identifiers were preserved. Included trials, contributing subsets, variance, denominators and models remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Article full text | Bibliographic identifier/entrance retained; actual availability/response unverified | External access not attempted; not acquired | False | Only URLs/identifiers were retained. Current external responses, files, identity and contents are unverified. Different titles/author displays under the same bibliographic identifiers were preserved. Included trials, contributing subsets, variance, denominators and models remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Publisher-original entrance | Bibliographic identifier/entrance retained; actual availability/response unverified | External access not attempted; not acquired | False | Only URLs/identifiers were retained. Current external responses, files, identity and contents are unverified. Different titles/author displays under the same bibliographic identifiers were preserved. Included trials, contributing subsets, variance, denominators and models remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Included-trial table | Actual existence/availability unverified; required original-material type | External access not attempted; not acquired | False | This is a required material type. Existence, URL and public availability were not verified; the material read is the retained summary. Different titles/author displays under the same bibliographic identifiers were preserved. Included trials, contributing subsets, variance, denominators and models remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Synthesis appendix | Actual existence/availability unverified; required original-material type | External access not attempted; not acquired | False | This is a required material type. Existence, URL and public availability were not verified; the material read is the retained summary. Different titles/author displays under the same bibliographic identifiers were preserved. Included trials, contributing subsets, variance, denominators and models remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |

### S02

The Effects of Ginger on Fasting Blood Sugar, Hemoglobin A1c, and Lipid Profiles in Patients with Type 2 Diabetes

[PubMed](https://pubmed.ncbi.nlm.nih.gov/29344037/)

Materials actually read: 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.  
Findings recorded in the summary: HbA1c changes -0.38 versus +0.22 percentage points, P<.0001; exact adjusted CI unverified  
Record level: The original record describes NF-κB as primary (1st) and HbA1c as secondary (2nd). Arm-specific changes are not calculated into a new between-group difference or adjusted confidence interval.  
Independent replication: The direct report's 50 randomized and 45 analyzed participants (23/22) are shared with another endpoint in record 3052 and are not added together. The 13 papers are not a unique-trial count. Included trials, overlap and unique participant counts in the synthesis are unverified.

| Material | Public availability | Access status | Actually read | Notes |
|---|---|---|---|---|
| Retained research/bibliographic summary | Existence verified in retained input | Local input read | Retained existing review summary read | The retained research/bibliographic summary was actually read; this is not full-text reading. Bibliographic NCT02666807 and the original unverified-registration field are each preserved. Planning comparison, exact adjusted CI, arm mapping of 23/22 and harm counts remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Bibliography/abstract | Bibliographic identifier/entrance retained; actual availability/response unverified | External access not attempted; not acquired | False | Only URLs/identifiers were retained. Current external responses, files, identity and contents are unverified. Bibliographic NCT02666807 and the original unverified-registration field are each preserved. Planning comparison, exact adjusted CI, arm mapping of 23/22 and harm counts remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Article full text | Bibliographic identifier/entrance retained; actual availability/response unverified | External access not attempted; not acquired | False | Only URLs/identifiers were retained. Current external responses, files, identity and contents are unverified. Bibliographic NCT02666807 and the original unverified-registration field are each preserved. Planning comparison, exact adjusted CI, arm mapping of 23/22 and harm counts remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Publisher-original entrance | Bibliographic identifier/entrance retained; actual availability/response unverified | External access not attempted; not acquired | False | Only URLs/identifiers were retained. Current external responses, files, identity and contents are unverified. Bibliographic NCT02666807 and the original unverified-registration field are each preserved. Planning comparison, exact adjusted CI, arm mapping of 23/22 and harm counts remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Trial registration | Bibliographic identifier/entrance retained; actual availability/response unverified | External access not attempted; not acquired | False | Only URLs/identifiers were retained. Current external responses, files, identity and contents are unverified. Bibliographic NCT02666807 and the original unverified-registration field are each preserved. Planning comparison, exact adjusted CI, arm mapping of 23/22 and harm counts remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Protocol | Actual existence/availability unverified; required original-material type | External access not attempted; not acquired | False | This is a required material type. Existence, URL and public availability were not verified; the material read is the retained summary. Bibliographic NCT02666807 and the original unverified-registration field are each preserved. Planning comparison, exact adjusted CI, arm mapping of 23/22 and harm counts remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Statistical analysis plan | Actual existence/availability unverified; required original-material type | External access not attempted; not acquired | False | This is a required material type. Existence, URL and public availability were not verified; the material read is the retained summary. Bibliographic NCT02666807 and the original unverified-registration field are each preserved. Planning comparison, exact adjusted CI, arm mapping of 23/22 and harm counts remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |
| Original result tables/participant flow | Actual existence/availability unverified; required original-material type | External access not attempted; not acquired | False | This is a required material type. Existence, URL and public availability were not verified; the material read is the retained summary. Bibliographic NCT02666807 and the original unverified-registration field are each preserved. Planning comparison, exact adjusted CI, arm mapping of 23/22 and harm counts remain unverified. The material record dated 2026-10-06 concerns retained-summary review. Condition 1.2 scope-wording revision and later preservation/reading-disclosure status changes were separately retained. The original verdict date 2026-09-08 and correction date 2026-09-14 are not new-search or full-text-reading dates. |

## 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 37 items. No new clinical search, verification-state change or scoring was performed.