Single-ingredient garlic tablets 900 mg/day; powder, processing, and active-constituent specifications unverified × Reduction of HbA1c in adults with type 2 diabetes

Required evidence, verification status and materials actually read
Item	AVerification status	BReading scope	CReview item	DCurrent findings	EWhy unverified	FRequired materials and conditions	GFurther research
1	Met	Full text not readStored summary read	N01 · Evidence conditionIs the selected 900 mg tablet, 24-week HbA1c comparison with placebo distinguished from other garlic claims?Required	The comparison concerns oral single-ingredient garlic tablets 900 mg/day for 24 weeks versus placebo for HbA1c in adults with established type 2 diabetes. Other glycemic/lipid outcomes and complications are separate. S01 S02 S03	Verification is limited to the identity of the original claim and its inclusion/exclusion boundaries; efficacy is not established.	Original locations for the current claim, formulation/route, selected dose, population, endpoint, comparator and timing	Review separate boundaries only when adding a new question. A new clinical trial is not required to identify this question.
2	Met	Full text not readStored summary read	N02 · Evidence conditionHave the 7-arm primary trial and two meta-analyses been kept from being double-counted as independent trials?Required	The 3 retained reports comprise a 7-arm primary trial and 2 meta-analyses. The 7 arms, 7 HbA1c effects and 27 RCTs are not added together to create a new independent-trial count. S01 S02 S03	This verifies report distinctions and the prohibition on double-counting. The reviews’ included trials and overlap with the primary trial/participants remain unverified.	Links among primary reports, reviews, included-trial tables, registrations and report families	First construct a study-level results table by comparing included-trial tables with registration numbers, authors and recruitment periods.
3	Met	Full text not readStored summary read	N03 · Evidence conditionAre the summaries actually read in this conversion distinguished from reading external papers, supplements and registrations?Required	The entire current 3062 retained summary was read, including Korean/English content, 3 evidence entries, 3 citations and 1 correction. Original papers, meta-analysis full texts/supplements and registrations were not accessed, acquired or read in this conversion. S01 S02 S03	This distinguishes actual reading in this conversion from historical statements; it does not verify full-text content.	Material identity, public/access status, acquisition, actual reading level, date, original location and identity	For lawfully acquired material, record the sections/tables read and file identity in a separate event.
4	Partly verified	Full text not readStored summary read	N04 · Evidence conditionAre adults with type 2 diabetes and the actual selection/baseline status in the selected primary trial verified?Required	The population is recorded as adults with established type 2 diabetes. Detailed diagnostic criteria, age distribution, baseline HbA1c, inclusion/exclusion and balance between arms are not verified in the retained summary. S01	Only the population label is verified; detailed selection and baseline tables remain unverified.	Diagnosis, age, baseline HbA1c, inclusion/exclusion, baseline medication/disease and balance between arms	Retrieve the primary trial’s Methods and baseline table to review population matching, separating direct population-specific studies when needed.
5	Partly verified	Full text not readStored summary read	N05 · Evidence conditionAre the source, specifications and active constituents of the selected single-ingredient garlic tablet verified?Required	The single-ingredient garlic tablet derives from Allium sativum L. cloves. Powder, extraction method and alliin/allicin specifications remain unverified; other garlic products are not substituted. S01	Tablet/source labels exist, but actual manufacturing/batch and constituent-specification matching remain unverified.	Exact product name, manufacturing/processing, powder/extraction method, batch, alliin/allicin assays and single-ingredient composition	First check the primary trial’s product documents and constituent assays; design formulation-specific effect studies as separate comparisons.
6	Partly verified	Full text not readStored summary read	N06 · Evidence conditionAre the per-dose amount, divided schedule and actual intake of 900 mg/day verified?Required	The selected 900 mg/day is recorded, but per-dose amount, divided frequency, actual intake/adherence and active-constituent amount remain unverified. S01	The daily-dose label is verified, but the actual schedule and administered exposure cannot be established.	Dosing table for the 900 mg arm, per-dose amount/frequency, actual intake, adherence and product content	Retrieve the primary trial’s dosing table and adherence data. Review direct dose comparisons separately for an optimal-dose claim.
7	Unverified	Full text not readStored summary read	N07 · Evidence conditionAre common glucose-lowering medication, changes and adherence in the placebo and 900 mg arms verified?Required	Whether stable glucose-lowering medication was maintained in common is unverified. Metformin is a separate active arm, so neither garlic nor placebo arms are described as both receiving metformin. S01	Actual data on common concomitant medication, changes by arm, rescue treatment and adherence are unavailable.	Common glucose-lowering drugs by arm, stable-treatment period, changes/rescue treatment, adherence and analytical handling	First check the primary trial’s Methods, concomitant-medication table, treatment changes and SAP to clarify the effect of interest.
8	Partly verified	Full text not readStored summary read	N08 · Evidence conditionAre the actual roles of placebo tablets and the separate metformin active arm verified?Required	The selected comparator is placebo tablets, while metformin is a separate active arm. Details of placebo composition, matching appearance and the active-arm schedule remain unverified. S01	Placebo/active-arm roles are distinguished, but actual arm composition and placebo matching details remain unresolved.	Allocation table for the 7 arms, placebo composition/appearance, active-arm dose, common treatment and selected contrast	Retrieve arm-composition/allocation tables and define a separate question before adding an active-drug comparison.
9	Partly verified	Full text not readStored summary read	N09 · Evidence conditionAre the actual schedules of 24-week treatment and measurements at 12 and 24 weeks verified?Required	The record describes 24-week treatment and measurements at 12 and 24 weeks. The selected endpoint is 24-week HbA1c; detailed schedules, actual completion and follow-up after stopping remain unverified. S01	Nominal treatment/measurement times are available, but actual follow-up schedules and completion are unverified.	Treatment/testing schedules by arm, baseline/12-week/24-week measurements, completion/stopping and follow-up duration	Retrieve original schedules and time-specific measurement/completion data; effects after stopping require separate follow-up.
10	Partly verified	Full text not readStored summary read	N10 · Evidence conditionAre the definition and units of absolute between-group HbA1c change verified?Required	The selected question concerns absolute between-group HbA1c change at 24 weeks. Only significance is retained for the primary trial, so the exact measure and computational contrast for the selected absolute effect remain unverified. S01	No table is available to compare the question’s endpoint/measure with the primary trial’s quantitative result.	Units, baseline/final values/change, contrast of interest, direction and analytical definition for 24-week HbA1c	Retrieve baseline/final/change values and contrast definitions from the original results table to link them to the selected effect.
11	Unverified	Full text not readStored summary read	N11 · Evidence conditionAre HbA1c assay methods, collection times and assessment procedures verified?Required	HbA1c measurement and the 24-week endpoint are recorded, but assay methods, standardization, assessor/laboratory blinding and procedures by arm are not verified in the retained summary. S01	The single-blind label alone does not identify who was blinded for which measurement.	Laboratory method/standardization, blood-collection timing, identical procedures by arm, assessor blinding and error handling	Acquire the original Methods, laboratory procedures and measurement-quality data.
12	Partly verified	Full text not readStored summary read	N12 · Evidence conditionCan the described 210 participants and 30 per arm be distinguished from actual 900 mg/placebo analysis denominators at 24 weeks?Required	The record describes 210 participants and 30 per arm; completion and ITT remain unverified. The 210 are not used as the actual analysis n for the selected 900 mg versus placebo comparison. S01	Original sample-size wording exists, but completed/analysis denominators by stage, arm and time are unresolved.	Recruitment/allocation, completion by arm, 24-week measurements, ITT/PP analysis n and participant flow diagram	Retrieve original flow diagrams and arm-by-time/analysis tables to link the actual denominators for the selected contrast.
13	Unverified	Full text not readStored summary read	N13 · Evidence conditionAre missingness, dropout, exclusions and analytical handling in the selected two arms verified?Required	Completion and ITT are recorded as unverified; counts of missingness, dropout and exclusions by arm and their handling are not verified. S01	Analysis losses, reasons and handling cannot be read from the currently retained material.	Missingness/dropout by arm, exclusion reasons, imputed values, ITT/PP and sensitivity analyses	Acquire participant flow diagrams, analysis plans and sensitivity-analysis material.
14	Partly verified	Full text not readStored summary read	N14 · Evidence conditionAre randomization methods, concealment and baseline balance in the 7-arm controlled trial verified?Required	The primary study is a 7-arm single-blind controlled trial with an unverified randomization method. A meta-analysis’s RCT title is not transferred as verification of the primary trial’s allocation procedures. S01 S02	Arm composition and controlled/blinding labels exist, but actual allocation, concealment and balance remain unresolved.	Original random sequence, allocation concealment, arm composition, baseline tables and recruitment process	Retrieve original Methods, allocation and baseline data to examine design limitations for the selected contrast.
15	Partly verified	Full text not readStored summary read	N15 · Evidence conditionAre the people blinded, placebo appearance and assessment blinding verified?Required	Only the single-blind label is retained; whether participants, clinicians or testers were blinded, placebo matching and unblinding remain unverified. S01	Material is unavailable to establish actual implementation beyond the blinding label.	Who was blinded, placebo appearance, blinding assessment/unblinding and tester procedures	Acquire the primary trial’s blinding Methods and placebo/measurement procedures.
16	Unverified	Full text not readStored summary read	N16 · Evidence conditionAre ITT/PP, adjustment, between-group contrasts and analytical models for the selected result verified?Required	Only P<.005 for garlic arms including 900 mg versus placebo, with completion and ITT unverified, is retained. Exact analysis populations, adjustment, models and the selected contrast definition remain unverified. S01	Significance wording alone cannot determine allocation effects, adherence effects or adjusted between-group changes.	Original SAP, ITT/PP analysis populations, baseline adjustment, between-/within-group comparisons and multi-arm contrast definitions	Retrieve the selected results table and analysis plan/model to link contrasts, denominators and adjustment.
17	Partly verified	Full text not readStored summary read	N17 · Evidence conditionAre the attribution of P<.005 for each garlic arm versus placebo and the selected effect’s limitations distinguished?Required	P<.005 for each garlic arm versus placebo, including 900 mg/day, is recorded. The selected absolute between-group difference and 95%CI remain unverified. S01	Significance wording is retained, but test/contrast, effect-size and multiple-comparison details cannot be established.	Original 24-week results table, contrasts by arm, tests, multiple comparisons and effect definition	Acquire the original results table and handling of multiple arms in testing, linking only the selected contrast separately.
18	Unverified	Full text not readStored summary read	N18 · Evidence conditionAre the absolute 24-week HbA1c effect and 95%CI for the selected 900 mg tablet verified?Required	The selected 900 mg absolute between-group %p, 95%CI and completed denominator remain unverified. Meta-analysis estimates of −0.50%p/−0.53%p are not established effects of the selected tablet. S01 S02 S03	The selected absolute effect, CI and analytical definitions are missing, so effect size, precision and importance cannot be established.	Baseline/final/change HbA1c in the selected/placebo arms, absolute between-group %p, variance, 95%CI and evidence for an important difference	Retrieve the primary trial’s selected results table, variance and denominators. If unavailable, quantitative replication research needs prespecified outcome reporting.
19	Unverified	Full text not readStored summary read	N19 · Evidence conditionCan the primary trial’s prespecified 24-week HbA1c rank 1 outcome hierarchy and analysis plan be compared with actual reporting?Required	A prespecified single rank 1 primary 24-week HbA1c endpoint in the primary trial is unverified, and the registration check is recorded as unable to verify. CRD42024628780 is a meta-analysis registration label. S01 S02	No direct comparison of the primary trial’s prespecified hierarchy, analysis plan or changes is available.	Contemporaneous primary-trial registration versions, protocol, SAP, endpoints/times and multi-arm change history	Retrieve contemporaneous registration, protocol and SAP to compare the prespecified hierarchy for 24-week HbA1c and the selected 900 mg contrast.
20	Partly verified	Full text not readStored summary read	N20 · Evidence conditionIs material available to distinguish the pooled HbA1c value from 3 trials and 7 effects from the selected tablet’s effect?Required (applying pooled evidence)	HbA1c in the first meta-analysis involves 3 trials and 7 effects, with WMD −0.50%p (95%CI −0.66~−0.33). Mixed formulations and background treatments mean this is not an established effect of the selected tablet. S01 S02	Pooled reported values/scale exist, but product, population, background-treatment and shared-control matching by effect remain unresolved.	HbA1c included trials, formulations/doses, populations, background treatments, times and effect/shared-control tables in the first meta-analysis	Retrieve included-trial tables and original results to link exposure, timing and shared controls for each HbA1c effect.
21	Partly verified	Full text not readStored summary read	N21 · Evidence conditionIs the overall scale of 27 RCTs and 1,619 participants across all endpoints distinguished from the HbA1c analysis scale?Required (applying pooled evidence)	The second meta-analysis records 27 RCTs and 1,619 participants across all endpoints, with HbA1c WMD −0.53%p (95%CI −0.86~−0.20). Replication counts for the selected formulation and HbA1c analysis n remain unverified. S03	Overall scale and a reported HbA1c mean exist, but endpoint-/formulation-specific denominators and matching for the selected question remain unresolved.	Endpoint-specific trials/participants, products, populations, times, background treatments and HbA1c analysis tables in the second meta-analysis	Retrieve endpoint-specific included-trial/effect tables, products and durations to separate the relevant HbA1c analysis.
22	Unverified	Full text not readStored summary read	N22 · Evidence conditionAre included-trial and unique-participant overlaps between the primary trial and the two reviews verified?Required (independent replication)	The original retained summary has no trial-family or included-trial/participant overlap table. Overlap between the primary trial and both reviews, and independent replications of the selected 900 mg, are unresolved. S01 S02 S03	The existence of same/different reports is known, but material is unavailable to establish included-trial and unique-participant relationships.	Included-trial tables for both reviews, primary/multi-arm reports, registration numbers, recruitment sites/periods and unique-participant links	First construct a report-family table, comparing recruitment periods, sites and registrations to verify overlap.
23	Partly verified	Full text not readStored summary read	N23 · Evidence conditionAre the scope and causes of I²96.4% and a positive publication-bias test in the first meta-analysis verified?Required (interpreting pooled evidence)	The first meta-analysis records I²=96.4% and a positive publication-bias test. Test methods, effect distributions, missing results and causes remain unverified in the retained summary. S02	Heterogeneity and test labels exist, but causes, test scope and missing results were not directly compared.	HbA1c effect distributions, I²/variance, heterogeneity/bias-test methods, prespecified hypotheses and missing results	Retrieve original forest plots, tests and formulation/background-treatment/time-specific results to review explanations for heterogeneity.
24	Met	Full text not readStored summary read	N24 · Evidence conditionHave −0.50%p and −0.53%p been kept from being forced into the same analysis or an actual conflict?Required	Retain the first meta-analysis’s −0.50%p/CI−0.66~−0.33 and the second’s −0.53%p/CI−0.86~−0.20 separately. Retain the second’s conclusion that additional high-quality RCTs are needed. S02 S03	Verification is limited to separately retaining each reported value and limitation; it does not establish homogeneity, independence or efficacy of the reviews.	Results/CIs, analysis scope, products/background treatments and endpoint-specific inclusion differences between the two reviews	Compare analytical scopes/included trials before separately reviewing whether an actual conflict concerns the same question.
25	Unverified	Full text not readStored summary read	N25 · Evidence conditionAre an optimal 900 mg dose, persistence after stopping and effects in specific subgroups verified?Supplementary; required for extension claims	A 7-arm primary trial and a dose-response meta-analysis title exist, but direct results for optimality of 900 mg, maintenance after stopping and prespecified subgroup interactions remain unverified. S01 S03	Direct results supporting extensions beyond the current selected 24-week HbA1c scope were not verified.	Direct dose contrasts, cessation/long-term follow-up, prespecified subgroups, interactions and separate estimates	Claims of an optimal dose, maintenance or subgroups require product-fixed direct contrasts and prespecified subgroup/follow-up studies.
26	Met	Full text not readStored summary read	N26 · Evidence conditionHas an HbA1c difference been kept from being extended to replacing diabetes medication or preventing complications?Supplementary; required for clinical extensions	Fasting glucose, HOMA-IR and lipids are kept separate from the selected HbA1c endpoint; results cannot be extended to replacing diabetes medication, preventing complications or identical effects from all garlic foods. S01 S02 S03	Verification concerns explicit interpretive boundaries; it does not judge an absence of clinical-event effects or safety of replacement treatment.	Original boundaries between the HbA1c surrogate and questions about medication replacement, complications and events	Separate claims of replacement treatment or complication prevention require direct comparisons/event data for those clinical questions.
27	Unverified	Full text not readStored summary read	N27 · Evidence conditionAre funding, product provision and conflicts of interest for the primary trial and both reviews actually verified?Supplementary; required for independence claims	Primary-trial funding/product provision are unverified; the two meta-analyses are recorded as academic research with mixed original-trial funding. Original I1 is historical and is not new independence certification. S01 S02 S03	Specific funding, provision, author employment/patents, declared COI and independent-institution relationships are unresolved.	Funding, product provision, author employment/patents, declared COI and institutional/independent-family relationships by report	Retrieve funding, provision, COI, author and institutional information separately for primary papers/reviews, recording the actual scope.
28	Unverified	Full text not readStored summary read	N28 · Evidence conditionAre hypoglycemic, gastrointestinal and bleeding events and collection methods for the selected formulation verified?Supplementary; required for safety claims	The original caution concerns monitoring hypoglycemia with glucose-lowering medication, gastrointestinal discomfort, bleeding risk and content variation. Actual primary-trial event definitions/collection, occurrence by arm, severity and stopping remain unverified. S01	Cautions are retained, but actual collection/counting is unverified, so no events or safety cannot be asserted.	Event definitions, active/spontaneous collection, severity, events/stopping by arm and missingness/dropout	Acquire primary-trial AE, stopping and collection tables; review safety questions separately with suitable harm designs.
29	Unverified	Full text not readStored summary read	N29 · Evidence conditionAre harm timing, denominators, follow-up and comparative risks in the selected two arms verified?Supplementary; required for comparative harms/incidence	Nominal 24 weeks, a description of 210 participants and 30 per arm exist, but harm occurrence/recovery, stopping/re-exposure, event denominators by arm, actual follow-up and comparative risks remain unverified. S01	Efficacy scale/duration cannot establish harm frequency or comparative risk.	Exposure/events, stopping/recovery times, exposed people/people with events/event counts by arm, follow-up time and comparative estimates	Retrieve original arm-specific AE/stopping/exposure-time tables; long-term and rare harms need suitable follow-up data.
30	Unverified	Full text not readStored summary read	N30 · Evidence conditionAre glucose-lowering medication, baseline disease, other exposures and alternative explanations for harms reviewed?Supplementary; required for causal harms	A caution to monitor hypoglycemia with glucose-lowering medication exists, but actual common medication is unverified, and baseline risks/other exposures and alternative event explanations by arm are unavailable. S01	Without actual event/co-exposure data, caution wording cannot be extended to a causal-risk estimate.	Concomitant medication by arm, baseline hypoglycemia/bleeding/disease, other exposures, changes and alternatives/adjustment	Link original concomitant-medication, baseline and event records to review alternative explanations for harm and temporal relationships.
31	Unverified	Full text not readStored summary read	N31 · Evidence conditionIs the scope of other independent harm records, long-term/rare risks and vulnerable groups verified?Supplementary; required for replication/overall safety	Harm-family tables, repeated events and direct long-term/rare-event/vulnerable-group data are not verified in the current 3 reports. The original caution does not certify overall safety. S01 S02 S03	Efficacy reports and pooled means alone cannot verify independent harm replications or long-term/vulnerable-group safety.	Unique harm families, regulatory reports versus recitations, long-term/rare events, special-population exposure and interactions	Review separate harm questions through unique-event links and suitable long-term follow-up/registration data.
32	Met	Full text not readStored summary read	N32 · Evidence conditionAre positive signals, the unverified selected effect and cautions explained at distinct levels?Required (current wording scope)	Positive P values/heterogeneous meta-analysis directions exist, but the selected 900 mg absolute effect, denominator and prespecified hierarchy remain unverified; safety retains the original Caution. Do not extend this to medication replacement or individual intake instructions. S01 S02 S03	Verification concerns currently supportable wording and limits on extension; it is not new certification of efficacy, causality or safety.	Boundaries between P/pooled direction, selected quantitative gaps, original cautions and incidence/causality/individual prescribing	Revisit each question/row if actual quantitative or harm data are added; retain original boundaries until then.
33	Met	Full text not readStored summary read	N33 · Evidence conditionAre the original 2026-09-08 reference date, 09-14 correction history, generic English wording and current scope distinguished?Required	The original verdict-review date is 2026-09-08, with a 09-14 history of correcting 3 English-placeholder fields. Current generic-principle wording in English evidence/citations remains exactly as recorded; this conversion is not specific numerical verification, a new search or a correction. S01 S02 S03	Verification concerns preservation of original dates, history, current values and work scope. Specific replacements in the English correction history were neither reconstructed nor certified; current publication/retraction status was not queried.	Original verdict-review date, corrections, original Korean/English/evidence/citation fields and current reading/search/publication-status scope	If original-data correction/evidence updating is separately requested, preserve the whole original and handle original locations/version changes as an event.
34	Met	Full text not readStored summary read	N34 · Evidence conditionHave original C46, Caution, all axes and empty subclaims been kept from being inherited as new condition states/grades?Required (historical preservation)	Original C46, Caution, B/S/R1/I1/EX/B1/CX, booleans/empty strings, subclaims=[] and bilingual synthesis/corrections are preserved unchanged. Row states are not new efficacy grades or recalculations of the original score. S01 S02 S03	Verification concerns preservation of original verdict history, types and boundaries; existing verification labels are not inherited as independent clinical certification in this conversion.	Original typed grade/score/safety, bilingual synthesis/grade decisions, axes, corrections and empty subclaims	Correcting the original verdict requires a separate request and version/change event. It is not rescoring in this sheet conversion.

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34 itemsWhat the statuses mean

Assessment scope

Stored-material review date: 2026-10-06
Original evidence cut-off: 2026-09-08
Scope actually checked: Retained Korean/English summaries and case-specific condition/application records. Full papers, supplements, registrations, plans and original data were not read.
What the dates mean: The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.
Population: Adults with established type 2 diabetes. Diagnosis, age, baseline HbA1c, inclusion/exclusion and balance between arms remain unverified.
Ingredient, formulation and route: Oral single-ingredient garlic tablets derived from Allium sativum L. cloves. Powder, extraction methods, manufacturing/batch and alliin/allicin specifications remain unverified.
Dose: Nominal 900 mg/day. Per-dose amount, divided frequency, actual intake, adherence and active-constituent amounts remain unverified.
Comparator: Placebo tablets. Metformin is a separate active arm, and common stable glucose-lowering medication is unverified. Placebo composition/appearance and actual arm schedules also remain unverified.
Measured outcome: Absolute between-group HbA1c change at 24 weeks. P<.005 was reported for each garlic arm versus placebo, but the selected absolute %p, 95%CI, completed/ITT denominators and prespecified single rank 1 primary hierarchy remain unverified.
Duration: 24-week treatment and measurements at 12 and 24 weeks. Actual schedules, completion and persistence after stopping remain unverified.
Questions outside this scope: Do not fill missing absolute effects/CIs for the selected 900 mg tablet using P values or meta-analysis means mixing other formulations.; The primary trial’s 7 arms, description of 210 participants and 30 per arm do not establish actual completed/ITT or selected-comparison analysis denominators.; The first meta-analysis’s HbA1c 3 trials/7 effects differ from the second’s 27 RCTs/1,619 participants across all endpoints. Included-trial/participant overlap and independent replication of the selected formulation remain unverified.; Keep fasting glucose, HOMA-IR and lipids separate from HbA1c. Do not extend results to replacing diabetes medication, preventing complications or identical effects from all garlic foods.; Raw garlic, powder, oil, aged garlic extract, black garlic, fermented garlic and isolated SAC do not share the same tablet specifications. Optimal dose, maintenance after stopping, subgroups and long-term/rare-event/vulnerable-group safety are separate questions.; Do not turn original caution wording into actual harm incidence, causal risks, safety certification or individual intake instructions.

Evidence and sources

The links below lead to the sources. A link alone does not mean the original source was read or its latest publication status verified.

S01 · Ashraf R et al. J Med Plants Res. 2011;5:2922-2928. DOI: 10.5897/JMPR.9000523.

Official source

Material type: Retained record: a 7-arm single-blind controlled trial. Randomization methods, concealment and baseline balance remain unverified.
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Findings recorded in the stored summary: P<.005 for each garlic arm versus placebo, including 900 mg/day. The selected absolute difference and CI remain unverified.
Record level: The prespecified single rank 1 primary status, absolute %p and 95%CI for 24-week HbA1c remain unverified. A description of 210 participants and 30 per arm does not establish completed/ITT denominators.
Study overlap and independent replication: Distinguish reports from the 7-arm primary trial and two meta-analyses. HbA1c 3 trials/7 effects are not counted as 7 independent trials; 27 RCTs/1,619 participants describe all endpoints. Primary-trial inclusion, overlap between reviews, unique-trial/participant totals and independent replication of the selected formulation remain unverified.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Retained verdict summary	Retained verdict summary read	Retained copy acquired; summary read	Stored existing review summary read	Relevant content in the retained Korean/English summary, evidence and citation was read. This does not establish acquisition or reading of the original clinical paper. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.
External bibliographic/abstract gateway	Bibliographic link retained; external material unread	External access not attempted; not acquired	Not read	This is an external link from the retained citation. The current response, bibliographic identity, abstract content and public access were not checked. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.
Original full-text/supplement gateway	DOI gateway retained; full text/supplements unread	External access not attempted; not acquired	Not read	This is a full-text/supplement gateway linked by the DOI in the retained citation. Provision, access, acquisition and reading remain unverified; access was not attempted in this conversion. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.
Primary-trial registration; location unverified	Registration location/version unverified; unread	External access not attempted; not acquired	Not read	Primary-trial registration is retained as unable to verify. The exact location/version is unverified; nonregistration is not established. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.

S02 · Ebrahimzadeh A et al. Nutr Metab Insights. 2026. PMID: 41695233. DOI: 10.1177/11786388251413660. PROSPERO CRD42024628780.

PubMed

Material type: Retained record: systematic review and meta-analysis of RCTs. This is distinguished from the primary trial and direct replication of the selected tablet.
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Findings recorded in the stored summary: WMD −0.50%p, 95%CI −0.66~−0.33; I²=96.4%; positive publication-bias test.
Record level: This pooled value mixes formulations/background treatments and is not an established effect of the selected 900 mg tablet. Matching by effect, bias-test methods/causes and missing results remain unverified.
Study overlap and independent replication: Distinguish reports from the 7-arm primary trial and two meta-analyses. HbA1c 3 trials/7 effects are not counted as 7 independent trials; 27 RCTs/1,619 participants describe all endpoints. Primary-trial inclusion, overlap between reviews, unique-trial/participant totals and independent replication of the selected formulation remain unverified.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Retained verdict summary	Retained verdict summary read	Retained copy acquired; summary read	Stored existing review summary read	Relevant content in the retained Korean/English summary, evidence and citation was read. This does not establish acquisition or reading of the original clinical paper. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.
External bibliographic/abstract gateway	Bibliographic link retained; external material unread	External access not attempted; not acquired	Not read	This is an external link from the retained citation. The current response, bibliographic identity, abstract content and public access were not checked. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.
Original full-text/supplement gateway	DOI gateway retained; full text/supplements unread	External access not attempted; not acquired	Not read	This is a full-text/supplement gateway linked by the DOI in the retained citation. Provision, access, acquisition and reading remain unverified; access was not attempted in this conversion. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.
Meta-analysis registration; PROSPERO CRD42024628780	Registration location/version unverified; unread	External access not attempted; not acquired	Not read	This is the review-registration ID in the retained citation. Its exact URL/version is unverified in this conversion, and it is not a primary-trial NCT. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.

S03 · Alsanie SA et al. Diabetes Res Clin Pract. 2026;239:113407. PMID: 42398591. DOI: 10.1016/j.diabres.2026.113407.

PubMed

Material type: Retained record: meta-analysis of RCTs with a reported GRADE assessment. Its title is not treated as official GRADE certification in this conversion.
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Findings recorded in the stored summary: HbA1c WMD −0.53%p, 95%CI −0.86~−0.20.
Record level: Retain the original conclusion that additional high-quality RCTs are needed. All-endpoint scale is not transferred to HbA1c or selected-tablet analysis denominators.
Study overlap and independent replication: Distinguish reports from the 7-arm primary trial and two meta-analyses. HbA1c 3 trials/7 effects are not counted as 7 independent trials; 27 RCTs/1,619 participants describe all endpoints. Primary-trial inclusion, overlap between reviews, unique-trial/participant totals and independent replication of the selected formulation remain unverified.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Retained verdict summary	Retained verdict summary read	Retained copy acquired; summary read	Stored existing review summary read	Relevant content in the retained Korean/English summary, evidence and citation was read. This does not establish acquisition or reading of the original clinical paper. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.
External bibliographic/abstract gateway	Bibliographic link retained; external material unread	External access not attempted; not acquired	Not read	This is an external link from the retained citation. The current response, bibliographic identity, abstract content and public access were not checked. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.
Original full-text/supplement gateway	DOI gateway retained; full text/supplements unread	External access not attempted; not acquired	Not read	This is a full-text/supplement gateway linked by the DOI in the retained citation. Provision, access, acquisition and reading remain unverified; access was not attempted in this conversion. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion.

Report counts versus independent study counts

Distinguish reports from the 7-arm primary trial and two meta-analyses. HbA1c 3 trials/7 effects are not counted as 7 independent trials; 27 RCTs/1,619 participants describe all endpoints. Primary-trial inclusion, overlap between reviews, unique-trial/participant totals and independent replication of the selected formulation remain unverified.

Review criteria

Version 1.0 · Criteria record date 2026-10-06. These are Chamgap's own application conditions, informed by the referenced methods. They do not constitute official assessment-tool certification or a new efficacy score.

N01 · Is the selected 900 mg tablet, 24-week HbA1c comparison with placebo distinguished from other garlic claims?

Required materials and conditions: Original locations for the current claim, formulation/route, selected dose, population, endpoint, comparator and timing
Conditions for verification: Link the current article’s selected 900 mg/day, 24-week HbA1c and placebo question to excluded endpoints.
Requirement and applicability: Required
Application exceptions: Verifying the question’s identity does not verify the absolute effect or formulation specifications.
Why this condition is needed: The specific HbA1c question with evidence gaps must first be fixed.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N02 · Have the 7-arm primary trial and two meta-analyses been kept from being double-counted as independent trials?

Required materials and conditions: Links among primary reports, reviews, included-trial tables, registrations and report families
Conditions for verification: Separate the roles of 1 primary-trial report and 2 meta-analysis reports, the same 7 arms, and unresolved included-trial overlap.
Requirement and applicability: Required
Application exceptions: Retain null values and unverified states when original family tables and unique-participant relationships are unavailable.
Why this condition is needed: Counting multiple arms and reviews as additional independent replications inflates the evidence.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N03 · Are the summaries actually read in this conversion distinguished from reading external papers, supplements and registrations?

Required materials and conditions: Material identity, public/access status, acquisition, actual reading level, date, original location and identity
Conditions for verification: Show actual reading of the local retained summary separately from external material unread in this conversion, and link summaries to their exact original locations.
Requirement and applicability: Required
Application exceptions: Access not attempted differs from inaccessible, failed access and 0 results.
Why this condition is needed: External links and retained summaries must not be represented as reading a paper’s full text.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N04 · Are adults with type 2 diabetes and the actual selection/baseline status in the selected primary trial verified?

Required materials and conditions: Diagnosis, age, baseline HbA1c, inclusion/exclusion, baseline medication/disease and balance between arms
Conditions for verification: Explain the match between the primary trial’s actual population and the selected question, and unverified baseline/selection details.
Requirement and applicability: Required
Application exceptions: Do not transfer figures from other populations or formulations to the selected arms.
Why this condition is needed: Sharing the label diabetes does not make a meta-analysis’s mixed populations applicable to this population.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N05 · Are the source, specifications and active constituents of the selected single-ingredient garlic tablet verified?

Required materials and conditions: Exact product name, manufacturing/processing, powder/extraction method, batch, alliin/allicin assays and single-ingredient composition
Conditions for verification: Distinguish the verified scope of an oral single-ingredient tablet from unverified specifications, and exclude other garlic formulations.
Requirement and applicability: Required
Application exceptions: The source Allium sativum cloves alone does not establish processing or active-constituent specifications.
Why this condition is needed: Food, oil, AGE and black garlic must not be mixed with the tablet’s actual exposure.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N06 · Are the per-dose amount, divided schedule and actual intake of 900 mg/day verified?

Required materials and conditions: Dosing table for the 900 mg arm, per-dose amount/frequency, actual intake, adherence and product content
Conditions for verification: Preserve the original 900 mg/day and record unverified divided dosing, intake and active-constituent amounts.
Requirement and applicability: Required
Application exceptions: Do not import other dose arms or meta-analysis dose-response results as the selected 900 mg schedule.
Why this condition is needed: Nominal daily dose must be distinguished from actual administered exposure to attribute the selected dose accurately.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N07 · Are common glucose-lowering medication, changes and adherence in the placebo and 900 mg arms verified?

Required materials and conditions: Common glucose-lowering drugs by arm, stable-treatment period, changes/rescue treatment, adherence and analytical handling
Conditions for verification: Distinguish common treatment in both arms from a separate active arm, recording the impact of unverified concomitant treatment/changes.
Requirement and applicability: Required
Application exceptions: Metformin is a separate active arm and is not assumed to be common maintenance medication.
Why this condition is needed: Contributions from other glucose-lowering treatment must not be attributed to the selected garlic effect.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N08 · Are the actual roles of placebo tablets and the separate metformin active arm verified?

Required materials and conditions: Allocation table for the 7 arms, placebo composition/appearance, active-arm dose, common treatment and selected contrast
Conditions for verification: Fix the selected contrast as 900 mg versus placebo, explaining unverified placebo details and actual active-arm composition.
Requirement and applicability: Required
Application exceptions: Do not substitute the separate active drug for placebo or common background treatment in both arms.
Why this condition is needed: Garlic versus placebo and garlic versus an active drug are different questions.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N09 · Are the actual schedules of 24-week treatment and measurements at 12 and 24 weeks verified?

Required materials and conditions: Treatment/testing schedules by arm, baseline/12-week/24-week measurements, completion/stopping and follow-up duration
Conditions for verification: Preserve the selected 24-week endpoint and 12-week interim measurement, leaving actual schedules/losses by arm unverified.
Requirement and applicability: Required
Application exceptions: Distinguish measurement times from actual completed follow-up and long-term maintenance duration.
Why this condition is needed: A 12-week interim value must not become the selected 24-week effect or a sustained effect after treatment stops.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N10 · Are the definition and units of absolute between-group HbA1c change verified?

Required materials and conditions: Units, baseline/final values/change, contrast of interest, direction and analytical definition for 24-week HbA1c
Conditions for verification: Distinguish the question of absolute between-group HbA1c change at 24 weeks from the level of actually reported results and unverified information.
Requirement and applicability: Required
Application exceptions: Do not interchange % and %p, within-group before/after and between-group comparisons, or final values and changes.
Why this condition is needed: Significance, glucose values and pooled means must not be mixed with the selected absolute HbA1c effect.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N11 · Are HbA1c assay methods, collection times and assessment procedures verified?

Required materials and conditions: Laboratory method/standardization, blood-collection timing, identical procedures by arm, assessor blinding and error handling
Conditions for verification: Explain the actual scope and unverified aspects of testing, collection, standardization and blinding.
Requirement and applicability: Required
Application exceptions: The objective-marker name HbA1c alone does not establish absence of measurement bias.
Why this condition is needed: Actual procedures are needed to examine whether differences in measurement conditions could explain result differences.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N12 · Can the described 210 participants and 30 per arm be distinguished from actual 900 mg/placebo analysis denominators at 24 weeks?

Required materials and conditions: Recruitment/allocation, completion by arm, 24-week measurements, ITT/PP analysis n and participant flow diagram
Conditions for verification: Preserve the original description of 210 participants and 30 per arm, distinguishing recruitment/allocation/completion/analysis roles and unverified information.
Requirement and applicability: Required
Application exceptions: Do not substitute 30 in each of 7 arms for an analysis of 210 in the 900 mg/placebo contrast.
Why this condition is needed: A described sample size must not be established as a completed/analysis denominator.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N13 · Are missingness, dropout, exclusions and analytical handling in the selected two arms verified?

Required materials and conditions: Missingness/dropout by arm, exclusion reasons, imputed values, ITT/PP and sensitivity analyses
Conditions for verification: Verify actual losses/handling for the selected 900 mg/placebo arms or explain that they remain unverified within the current material.
Requirement and applicability: Required
Application exceptions: Do not fill losses absent from the current summary with 0 or 100% completion.
Why this condition is needed: Original sample size alone cannot establish that no analysis losses occurred.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N14 · Are randomization methods, concealment and baseline balance in the 7-arm controlled trial verified?

Required materials and conditions: Original random sequence, allocation concealment, arm composition, baseline tables and recruitment process
Conditions for verification: Distinguish the 7-arm single-blind controlled-trial wording from unverified allocation/concealment/balance.
Requirement and applicability: Required
Application exceptions: An unverified randomization method does not establish that the trial was nonrandomized.
Why this condition is needed: Controlled-trial/review-RCT labels must not be inherited as adequate allocation in the primary trial.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N15 · Are the people blinded, placebo appearance and assessment blinding verified?

Required materials and conditions: Who was blinded, placebo appearance, blinding assessment/unblinding and tester procedures
Conditions for verification: Distinguish original blinding wording from unverified people and actual procedures for each outcome.
Requirement and applicability: Required
Application exceptions: An objective endpoint does not erase unverified performance/concomitant-treatment differences or measurement procedures.
Why this condition is needed: The single-blind label must not be read as resolving all performance/measurement bias.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N16 · Are ITT/PP, adjustment, between-group contrasts and analytical models for the selected result verified?

Required materials and conditions: Original SAP, ITT/PP analysis populations, baseline adjustment, between-/within-group comparisons and multi-arm contrast definitions
Conditions for verification: Compare the absolute between-group effect of interest at 24 weeks with actual analytical definitions and unverified aspects.
Requirement and applicability: Required
Application exceptions: Do not arbitrarily fill the analysis as ITT or turn within-group improvement into an additional effect.
Why this condition is needed: Without knowing which effect is estimated, the P value cannot be read as the selected absolute between-group effect.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N17 · Are the attribution of P<.005 for each garlic arm versus placebo and the selected effect’s limitations distinguished?

Required materials and conditions: Original 24-week results table, contrasts by arm, tests, multiple comparisons and effect definition
Conditions for verification: Attribute P<.005 to the original statement and show alongside it that the 900 mg absolute effect and CI remain unverified.
Requirement and applicability: Required
Application exceptions: Do not convert each dose arm’s P value into the selected absolute %p or CI, or pool them as identical effects.
Why this condition is needed: P values and effect size/precision provide different information.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N18 · Are the absolute 24-week HbA1c effect and 95%CI for the selected 900 mg tablet verified?

Required materials and conditions: Baseline/final/change HbA1c in the selected/placebo arms, absolute between-group %p, variance, 95%CI and evidence for an important difference
Conditions for verification: Link the selected 900 mg absolute effect, interval and evidence for importance, or leave them precisely unverified.
Requirement and applicability: Required
Application exceptions: Do not calculate and fill missing effects or CIs from P values or meta-analysis WMDs for other formulations.
Why this condition is needed: Primary-trial counts, significance and pooled means cannot determine the selected effect’s size or adequacy.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N19 · Can the primary trial’s prespecified 24-week HbA1c rank 1 outcome hierarchy and analysis plan be compared with actual reporting?

Required materials and conditions: Contemporaneous primary-trial registration versions, protocol, SAP, endpoints/times and multi-arm change history
Conditions for verification: Explicitly state that a prespecified single rank 1 primary endpoint is unverified and registration/SAP were not compared, separating review registration.
Requirement and applicability: Required
Application exceptions: Unable to verify registration does not establish nonregistration; do not use review PROSPERO as a primary-trial NCT.
Why this condition is needed: Comparing prespecified plans with reports is needed to examine favorable selection of endpoints, times or arms.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N20 · Is material available to distinguish the pooled HbA1c value from 3 trials and 7 effects from the selected tablet’s effect?

Required materials and conditions: HbA1c included trials, formulations/doses, populations, background treatments, times and effect/shared-control tables in the first meta-analysis
Conditions for verification: Explain the reported WMD/CI, roles of 3 trials and 7 effects, mixed formulations/background treatments and indirectness for the selected effect.
Requirement and applicability: Required (applying pooled evidence)
Application exceptions: Do not substitute 7 independent trials for 3 trials and 7 effects.
Why this condition is needed: Multi-arm effects from the same trial and varied formulations/concomitant treatments must not be pooled as the selected 900 mg effect.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N21 · Is the overall scale of 27 RCTs and 1,619 participants across all endpoints distinguished from the HbA1c analysis scale?

Required materials and conditions: Endpoint-specific trials/participants, products, populations, times, background treatments and HbA1c analysis tables in the second meta-analysis
Conditions for verification: Preserve overall scale and HbA1c WMD/CI separately, marking endpoint-specific denominators and directness unverified.
Requirement and applicability: Required (applying pooled evidence)
Application exceptions: The 27 RCTs and 1,619 participants describe all endpoints; do not transfer them as unique HbA1c analysis n.
Why this condition is needed: Reading all-endpoint scale as the sample size for HbA1c or the selected 900 mg comparison overstates precision.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N22 · Are included-trial and unique-participant overlaps between the primary trial and the two reviews verified?

Required materials and conditions: Included-trial tables for both reviews, primary/multi-arm reports, registration numbers, recruitment sites/periods and unique-participant links
Conditions for verification: Explain the verified scope of primary-trial inclusion, overlap between reviews and unique-study/participant counts.
Requirement and applicability: Required (independent replication)
Application exceptions: Different bibliographic DOIs for reviews alone do not establish independent included trials/participants.
Why this condition is needed: Different reviews citing the same primary trial do not add independent replication evidence.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N23 · Are the scope and causes of I²96.4% and a positive publication-bias test in the first meta-analysis verified?

Required materials and conditions: HbA1c effect distributions, I²/variance, heterogeneity/bias-test methods, prespecified hypotheses and missing results
Conditions for verification: Link reported heterogeneity, the positive test and unverified methods/causes to limitations in applying results to the selected formulation.
Requirement and applicability: Required (interpreting pooled evidence)
Application exceptions: A positive test alone must not generate a missing-trial count or corrected effect, or invalidate all trials.
Why this condition is needed: The positive pooled mean and extreme heterogeneity must both be retained.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N24 · Have −0.50%p and −0.53%p been kept from being forced into the same analysis or an actual conflict?

Required materials and conditions: Results/CIs, analysis scope, products/background treatments and endpoint-specific inclusion differences between the two reviews
Conditions for verification: Attribute both original reported values/CIs, heterogeneity and the need for additional high-quality RCTs to their respective sources without combining them.
Requirement and applicability: Required
Application exceptions: Differences between review estimates alone do not establish conflicting data, equivalence or an effect of 0.
Why this condition is needed: Differences between means with different analytical scopes must neither be ignored nor declared conflicts about the same question.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N25 · Are an optimal 900 mg dose, persistence after stopping and effects in specific subgroups verified?

Required materials and conditions: Direct dose contrasts, cessation/long-term follow-up, prespecified subgroups, interactions and separate estimates
Conditions for verification: Distinguish the 7-arm/review dose-response labels from unverified direct extension results for 900 mg.
Requirement and applicability: Supplementary; required for extension claims
Application exceptions: Do not require all extension research as mandatory for the current narrow 24-week HbA1c question.
Why this condition is needed: The selected 24-week result must not be extended to an optimal dose, long-term maintenance or effects in special populations.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N26 · Has an HbA1c difference been kept from being extended to replacing diabetes medication or preventing complications?

Required materials and conditions: Original boundaries between the HbA1c surrogate and questions about medication replacement, complications and events
Conditions for verification: Explicitly prohibit extensions to medication replacement, complications and effects from all garlic foods.
Requirement and applicability: Supplementary; required for clinical extensions
Application exceptions: Do not require event trials as mandatory to verify the numerical HbA1c question.
Why this condition is needed: A surrogate-marker change does not automatically answer questions about other treatments or clinical events.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N27 · Are funding, product provision and conflicts of interest for the primary trial and both reviews actually verified?

Required materials and conditions: Funding, product provision, author employment/patents, declared COI and institutional/independent-family relationships by report
Conditions for verification: Separate unverified primary-trial funding/product provision from the reviews’ wording of academic research and mixed primary-trial funding.
Requirement and applicability: Supplementary; required for independence claims
Application exceptions: Do not inherit an academic-research label or original I1 as independent funding or replication certification.
Why this condition is needed: Unverified funding must not be credited as independent funding or absence of conflicts.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N28 · Are hypoglycemic, gastrointestinal and bleeding events and collection methods for the selected formulation verified?

Required materials and conditions: Event definitions, active/spontaneous collection, severity, events/stopping by arm and missingness/dropout
Conditions for verification: Separate caution wording from actual events/collection and the boundaries between not reported and not read.
Requirement and applicability: Supplementary; required for safety claims
Application exceptions: Unverified harm data do not delete HbA1c reports; record separate states.
Why this condition is needed: General caution wording must not become actual primary-trial adverse-event counts or absence of harm.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N29 · Are harm timing, denominators, follow-up and comparative risks in the selected two arms verified?

Required materials and conditions: Exposure/events, stopping/recovery times, exposed people/people with events/event counts by arm, follow-up time and comparative estimates
Conditions for verification: Link reporting of actual harm timing, controls, denominators/duration to currently unverified information.
Requirement and applicability: Supplementary; required for comparative harms/incidence
Application exceptions: Do not calculate harm risk from efficacy times/sample sizes or extrapolate background rates.
Why this condition is needed: The scale of 210 participants/30 per arm and the 24-week schedule must not automatically become harm incidence or causal denominators.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N30 · Are glucose-lowering medication, baseline disease, other exposures and alternative explanations for harms reviewed?

Required materials and conditions: Concomitant medication by arm, baseline hypoglycemia/bleeding/disease, other exposures, changes and alternatives/adjustment
Conditions for verification: Distinguish the warning context from the verified scope of actual co-exposure, underlying disease and alternatives.
Requirement and applicability: Supplementary; required for causal harms
Application exceptions: Missing alternative-explanation information does not establish that no other causes existed.
Why this condition is needed: A concomitant-use caution alone must not attribute actual events solely to garlic.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N31 · Is the scope of other independent harm records, long-term/rare risks and vulnerable groups verified?

Required materials and conditions: Unique harm families, regulatory reports versus recitations, long-term/rare events, special-population exposure and interactions
Conditions for verification: Separate direct harm replications and unverified long-term/vulnerable-group information from original efficacy material.
Requirement and applicability: Supplementary; required for replication/overall safety
Application exceptions: Do not require every rare-harm study for the current HbA1c question or add together repeated citations of the same event.
Why this condition is needed: Short-term efficacy trials/reviews must not be promoted to independent harm replications or overall safety.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N32 · Are positive signals, the unverified selected effect and cautions explained at distinct levels?

Required materials and conditions: Boundaries between P/pooled direction, selected quantitative gaps, original cautions and incidence/causality/individual prescribing
Conditions for verification: Retain positive statements alongside unverified selected effects/harms, explicitly explaining limits on causal/incidence extensions.
Requirement and applicability: Required (current wording scope)
Application exceptions: Do not revise uncertainty and caution into a new safety grade or individual intake instructions.
Why this condition is needed: Positive efficacy signals must not become safety, medication replacement or an established selected quantitative effect.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N33 · Are the original 2026-09-08 reference date, 09-14 correction history, generic English wording and current scope distinguished?

Required materials and conditions: Original verdict-review date, corrections, original Korean/English/evidence/citation fields and current reading/search/publication-status scope
Conditions for verification: Link original dates, corrections/English wording and actual reading of the retained summary to the absence of searching/external reading; do not label no response as 0 studies.
Requirement and applicability: Required
Application exceptions: Preserve original generic English principles; no translation correction or historical reconstruction is performed in this conversion.
Why this condition is needed: Historical access/correction labels must not be backdated into full-text reading, a current search or specific English verification in this conversion.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

N34 · Have original C46, Caution, all axes and empty subclaims been kept from being inherited as new condition states/grades?

Required materials and conditions: Original typed grade/score/safety, bilingual synthesis/grade decisions, axes, corrections and empty subclaims
Conditions for verification: Link original values/types unchanged, explaining that no new score/grade or subclaim index is generated.
Requirement and applicability: Required (historical preservation)
Application exceptions: Do not display original verification labels or C46 as independent clinical certification, a new efficacy score or a condition-fulfillment rate.
Why this condition is needed: Conversion-table states preserve information by condition and must not automatically recalculate the original efficacy verdict.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Referenced methods and the sections actually reviewed

M03 · Cochrane Handbook 6.5 (2024), chapter updated 2023-08

Official methodology · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13

Referenced principle: Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.
Extent of review: 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

Official methodology · §4.5, §4.6.1–4.6.3, MECIR C42

Referenced principle: Distinguish studies from reports and link them; do not omit a study solely because results are unreported.
Extent of review: 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

Official methodology · §8.1–8.2.3, Table 8.2.a

Referenced principle: Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.
Extent of review: 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

Official methodology · §15.2.4, §15.3.1–15.3.3

Referenced principle: Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.
Extent of review: 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

Official methodology · §19.1.2, §19.2.1–19.2.4

Referenced principle: Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.
Extent of review: Retained method-application records were reused. External originals were not reread and method content was not reassessed.

What the statuses mean

Partly verified: Some required facts are known, but the stated conditions involving analyses, populations, formulation or denominators remain unverified.
Unverified: Direct information is unverified in the retained record. This does not establish an effect of 0, no studies or absence of harm.
Review incomplete: Reading of the material or review of a condition is incomplete. This does not establish absence of studies or efficacy.
Not reported: The needed information was not found in material actually read. This is distinguished from unread material.
Inaccessible: Access was actually attempted but the material was not acquired. This is distinguished from access not attempted.
Insufficient evidence matching the conditions: Evidence directly matching the defined question and conditions is insufficient. This does not establish absence of all research.
Not applicable: A specific condition does not apply to the question. This does not substitute for unread or unverified material.
Conflicting data: This covers discrepancies in material about the same question, denominator and timing. Differences between separate questions are not automatically treated as conflicts.
Met: The retained identity, observation or scope required by this item was checked within stated limits. This does not establish efficacy or full-text certification.

Change history

2026-10-26 · Public page/material version 1.0

The public view and materials were prepared from the existing 34 items. No new clinical search, verification-state change or scoring was performed.

The stored-material review date (2026-10-06) and original evidence cut-off (2026-09-08) were retained unchanged.

Researcher downloads

These materials provide the same evidence, scope and verification status as this page.

View all item details

N01 · Is the selected 900 mg tablet, 24-week HbA1c comparison with placebo distinguished from other garlic claims?

Current findings: The comparison concerns oral single-ingredient garlic tablets 900 mg/day for 24 weeks versus placebo for HbA1c in adults with established type 2 diabetes. Other glycemic/lipid outcomes and complications are separate.
Verification status: Met
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Verification is limited to the identity of the original claim and its inclusion/exclusion boundaries; efficacy is not established.
Reason for missing information: Verification is limited to the identity of the original claim and its inclusion/exclusion boundaries; efficacy is not established.
Required materials and conditions: Original locations for the current claim, formulation/route, selected dose, population, endpoint, comparator and timing
Materials to obtain first: Original locations for the current claim, formulation/route, selected dose, population, endpoint, comparator and timing
Further research: Review separate boundaries only when adding a new question. A new clinical trial is not required to identify this question.
Remaining uncertainty: Verification is limited to the identity of the original claim and its inclusion/exclusion boundaries; efficacy is not established.
Conditions for verification: Link the current article’s selected 900 mg/day, 24-week HbA1c and placebo question to excluded endpoints.
Why this condition is needed: The specific HbA1c question with evidence gaps must first be fixed.
Application exceptions: Verifying the question’s identity does not verify the absolute effect or formulation specifications.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03

N02 · Have the 7-arm primary trial and two meta-analyses been kept from being double-counted as independent trials?

Current findings: The 3 retained reports comprise a 7-arm primary trial and 2 meta-analyses. The 7 arms, 7 HbA1c effects and 27 RCTs are not added together to create a new independent-trial count.
Verification status: Met
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: This verifies report distinctions and the prohibition on double-counting. The reviews’ included trials and overlap with the primary trial/participants remain unverified.
Reason for missing information: This verifies report distinctions and the prohibition on double-counting. The reviews’ included trials and overlap with the primary trial/participants remain unverified.
Required materials and conditions: Links among primary reports, reviews, included-trial tables, registrations and report families
Materials to obtain first: Links among primary reports, reviews, included-trial tables, registrations and report families
Further research: First construct a study-level results table by comparing included-trial tables with registration numbers, authors and recruitment periods.
Remaining uncertainty: This verifies report distinctions and the prohibition on double-counting. The reviews’ included trials and overlap with the primary trial/participants remain unverified.
Conditions for verification: Separate the roles of 1 primary-trial report and 2 meta-analysis reports, the same 7 arms, and unresolved included-trial overlap.
Why this condition is needed: Counting multiple arms and reviews as additional independent replications inflates the evidence.
Application exceptions: Retain null values and unverified states when original family tables and unique-participant relationships are unavailable.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03

N03 · Are the summaries actually read in this conversion distinguished from reading external papers, supplements and registrations?

Current findings: The entire current 3062 retained summary was read, including Korean/English content, 3 evidence entries, 3 citations and 1 correction. Original papers, meta-analysis full texts/supplements and registrations were not accessed, acquired or read in this conversion.
Verification status: Met
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: This distinguishes actual reading in this conversion from historical statements; it does not verify full-text content.
Reason for missing information: This distinguishes actual reading in this conversion from historical statements; it does not verify full-text content.
Required materials and conditions: Material identity, public/access status, acquisition, actual reading level, date, original location and identity
Materials to obtain first: Material identity, public/access status, acquisition, actual reading level, date, original location and identity
Further research: For lawfully acquired material, record the sections/tables read and file identity in a separate event.
Remaining uncertainty: This distinguishes actual reading in this conversion from historical statements; it does not verify full-text content.
Conditions for verification: Show actual reading of the local retained summary separately from external material unread in this conversion, and link summaries to their exact original locations.
Why this condition is needed: External links and retained summaries must not be represented as reading a paper’s full text.
Application exceptions: Access not attempted differs from inaccessible, failed access and 0 results.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03

N04 · Are adults with type 2 diabetes and the actual selection/baseline status in the selected primary trial verified?

Current findings: The population is recorded as adults with established type 2 diabetes. Detailed diagnostic criteria, age distribution, baseline HbA1c, inclusion/exclusion and balance between arms are not verified in the retained summary.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Only the population label is verified; detailed selection and baseline tables remain unverified.
Reason for missing information: Only the population label is verified; detailed selection and baseline tables remain unverified.
Required materials and conditions: Diagnosis, age, baseline HbA1c, inclusion/exclusion, baseline medication/disease and balance between arms
Materials to obtain first: Diagnosis, age, baseline HbA1c, inclusion/exclusion, baseline medication/disease and balance between arms
Further research: Retrieve the primary trial’s Methods and baseline table to review population matching, separating direct population-specific studies when needed.
Remaining uncertainty: Only the population label is verified; detailed selection and baseline tables remain unverified.
Conditions for verification: Explain the match between the primary trial’s actual population and the selected question, and unverified baseline/selection details.
Why this condition is needed: Sharing the label diabetes does not make a meta-analysis’s mixed populations applicable to this population.
Application exceptions: Do not transfer figures from other populations or formulations to the selected arms.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N05 · Are the source, specifications and active constituents of the selected single-ingredient garlic tablet verified?

Current findings: The single-ingredient garlic tablet derives from Allium sativum L. cloves. Powder, extraction method and alliin/allicin specifications remain unverified; other garlic products are not substituted.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Tablet/source labels exist, but actual manufacturing/batch and constituent-specification matching remain unverified.
Reason for missing information: Tablet/source labels exist, but actual manufacturing/batch and constituent-specification matching remain unverified.
Required materials and conditions: Exact product name, manufacturing/processing, powder/extraction method, batch, alliin/allicin assays and single-ingredient composition
Materials to obtain first: Exact product name, manufacturing/processing, powder/extraction method, batch, alliin/allicin assays and single-ingredient composition
Further research: First check the primary trial’s product documents and constituent assays; design formulation-specific effect studies as separate comparisons.
Remaining uncertainty: Tablet/source labels exist, but actual manufacturing/batch and constituent-specification matching remain unverified.
Conditions for verification: Distinguish the verified scope of an oral single-ingredient tablet from unverified specifications, and exclude other garlic formulations.
Why this condition is needed: Food, oil, AGE and black garlic must not be mixed with the tablet’s actual exposure.
Application exceptions: The source Allium sativum cloves alone does not establish processing or active-constituent specifications.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N06 · Are the per-dose amount, divided schedule and actual intake of 900 mg/day verified?

Current findings: The selected 900 mg/day is recorded, but per-dose amount, divided frequency, actual intake/adherence and active-constituent amount remain unverified.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: The daily-dose label is verified, but the actual schedule and administered exposure cannot be established.
Reason for missing information: The daily-dose label is verified, but the actual schedule and administered exposure cannot be established.
Required materials and conditions: Dosing table for the 900 mg arm, per-dose amount/frequency, actual intake, adherence and product content
Materials to obtain first: Dosing table for the 900 mg arm, per-dose amount/frequency, actual intake, adherence and product content
Further research: Retrieve the primary trial’s dosing table and adherence data. Review direct dose comparisons separately for an optimal-dose claim.
Remaining uncertainty: The daily-dose label is verified, but the actual schedule and administered exposure cannot be established.
Conditions for verification: Preserve the original 900 mg/day and record unverified divided dosing, intake and active-constituent amounts.
Why this condition is needed: Nominal daily dose must be distinguished from actual administered exposure to attribute the selected dose accurately.
Application exceptions: Do not import other dose arms or meta-analysis dose-response results as the selected 900 mg schedule.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N07 · Are common glucose-lowering medication, changes and adherence in the placebo and 900 mg arms verified?

Current findings: Whether stable glucose-lowering medication was maintained in common is unverified. Metformin is a separate active arm, so neither garlic nor placebo arms are described as both receiving metformin.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Actual data on common concomitant medication, changes by arm, rescue treatment and adherence are unavailable.
Reason for missing information: Actual data on common concomitant medication, changes by arm, rescue treatment and adherence are unavailable.
Required materials and conditions: Common glucose-lowering drugs by arm, stable-treatment period, changes/rescue treatment, adherence and analytical handling
Materials to obtain first: Common glucose-lowering drugs by arm, stable-treatment period, changes/rescue treatment, adherence and analytical handling
Further research: First check the primary trial’s Methods, concomitant-medication table, treatment changes and SAP to clarify the effect of interest.
Remaining uncertainty: Actual data on common concomitant medication, changes by arm, rescue treatment and adherence are unavailable.
Conditions for verification: Distinguish common treatment in both arms from a separate active arm, recording the impact of unverified concomitant treatment/changes.
Why this condition is needed: Contributions from other glucose-lowering treatment must not be attributed to the selected garlic effect.
Application exceptions: Metformin is a separate active arm and is not assumed to be common maintenance medication.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N08 · Are the actual roles of placebo tablets and the separate metformin active arm verified?

Current findings: The selected comparator is placebo tablets, while metformin is a separate active arm. Details of placebo composition, matching appearance and the active-arm schedule remain unverified.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Placebo/active-arm roles are distinguished, but actual arm composition and placebo matching details remain unresolved.
Reason for missing information: Placebo/active-arm roles are distinguished, but actual arm composition and placebo matching details remain unresolved.
Required materials and conditions: Allocation table for the 7 arms, placebo composition/appearance, active-arm dose, common treatment and selected contrast
Materials to obtain first: Allocation table for the 7 arms, placebo composition/appearance, active-arm dose, common treatment and selected contrast
Further research: Retrieve arm-composition/allocation tables and define a separate question before adding an active-drug comparison.
Remaining uncertainty: Placebo/active-arm roles are distinguished, but actual arm composition and placebo matching details remain unresolved.
Conditions for verification: Fix the selected contrast as 900 mg versus placebo, explaining unverified placebo details and actual active-arm composition.
Why this condition is needed: Garlic versus placebo and garlic versus an active drug are different questions.
Application exceptions: Do not substitute the separate active drug for placebo or common background treatment in both arms.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N09 · Are the actual schedules of 24-week treatment and measurements at 12 and 24 weeks verified?

Current findings: The record describes 24-week treatment and measurements at 12 and 24 weeks. The selected endpoint is 24-week HbA1c; detailed schedules, actual completion and follow-up after stopping remain unverified.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Nominal treatment/measurement times are available, but actual follow-up schedules and completion are unverified.
Reason for missing information: Nominal treatment/measurement times are available, but actual follow-up schedules and completion are unverified.
Required materials and conditions: Treatment/testing schedules by arm, baseline/12-week/24-week measurements, completion/stopping and follow-up duration
Materials to obtain first: Treatment/testing schedules by arm, baseline/12-week/24-week measurements, completion/stopping and follow-up duration
Further research: Retrieve original schedules and time-specific measurement/completion data; effects after stopping require separate follow-up.
Remaining uncertainty: Nominal treatment/measurement times are available, but actual follow-up schedules and completion are unverified.
Conditions for verification: Preserve the selected 24-week endpoint and 12-week interim measurement, leaving actual schedules/losses by arm unverified.
Why this condition is needed: A 12-week interim value must not become the selected 24-week effect or a sustained effect after treatment stops.
Application exceptions: Distinguish measurement times from actual completed follow-up and long-term maintenance duration.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N10 · Are the definition and units of absolute between-group HbA1c change verified?

Current findings: The selected question concerns absolute between-group HbA1c change at 24 weeks. Only significance is retained for the primary trial, so the exact measure and computational contrast for the selected absolute effect remain unverified.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: No table is available to compare the question’s endpoint/measure with the primary trial’s quantitative result.
Reason for missing information: No table is available to compare the question’s endpoint/measure with the primary trial’s quantitative result.
Required materials and conditions: Units, baseline/final values/change, contrast of interest, direction and analytical definition for 24-week HbA1c
Materials to obtain first: Units, baseline/final values/change, contrast of interest, direction and analytical definition for 24-week HbA1c
Further research: Retrieve baseline/final/change values and contrast definitions from the original results table to link them to the selected effect.
Remaining uncertainty: No table is available to compare the question’s endpoint/measure with the primary trial’s quantitative result.
Conditions for verification: Distinguish the question of absolute between-group HbA1c change at 24 weeks from the level of actually reported results and unverified information.
Why this condition is needed: Significance, glucose values and pooled means must not be mixed with the selected absolute HbA1c effect.
Application exceptions: Do not interchange % and %p, within-group before/after and between-group comparisons, or final values and changes.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N11 · Are HbA1c assay methods, collection times and assessment procedures verified?

Current findings: HbA1c measurement and the 24-week endpoint are recorded, but assay methods, standardization, assessor/laboratory blinding and procedures by arm are not verified in the retained summary.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: The single-blind label alone does not identify who was blinded for which measurement.
Reason for missing information: The single-blind label alone does not identify who was blinded for which measurement.
Required materials and conditions: Laboratory method/standardization, blood-collection timing, identical procedures by arm, assessor blinding and error handling
Materials to obtain first: Laboratory method/standardization, blood-collection timing, identical procedures by arm, assessor blinding and error handling
Further research: Acquire the original Methods, laboratory procedures and measurement-quality data.
Remaining uncertainty: The single-blind label alone does not identify who was blinded for which measurement.
Conditions for verification: Explain the actual scope and unverified aspects of testing, collection, standardization and blinding.
Why this condition is needed: Actual procedures are needed to examine whether differences in measurement conditions could explain result differences.
Application exceptions: The objective-marker name HbA1c alone does not establish absence of measurement bias.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N12 · Can the described 210 participants and 30 per arm be distinguished from actual 900 mg/placebo analysis denominators at 24 weeks?

Current findings: The record describes 210 participants and 30 per arm; completion and ITT remain unverified. The 210 are not used as the actual analysis n for the selected 900 mg versus placebo comparison.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Original sample-size wording exists, but completed/analysis denominators by stage, arm and time are unresolved.
Reason for missing information: Original sample-size wording exists, but completed/analysis denominators by stage, arm and time are unresolved.
Required materials and conditions: Recruitment/allocation, completion by arm, 24-week measurements, ITT/PP analysis n and participant flow diagram
Materials to obtain first: Recruitment/allocation, completion by arm, 24-week measurements, ITT/PP analysis n and participant flow diagram
Further research: Retrieve original flow diagrams and arm-by-time/analysis tables to link the actual denominators for the selected contrast.
Remaining uncertainty: Original sample-size wording exists, but completed/analysis denominators by stage, arm and time are unresolved.
Conditions for verification: Preserve the original description of 210 participants and 30 per arm, distinguishing recruitment/allocation/completion/analysis roles and unverified information.
Why this condition is needed: A described sample size must not be established as a completed/analysis denominator.
Application exceptions: Do not substitute 30 in each of 7 arms for an analysis of 210 in the 900 mg/placebo contrast.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N13 · Are missingness, dropout, exclusions and analytical handling in the selected two arms verified?

Current findings: Completion and ITT are recorded as unverified; counts of missingness, dropout and exclusions by arm and their handling are not verified.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Analysis losses, reasons and handling cannot be read from the currently retained material.
Reason for missing information: Analysis losses, reasons and handling cannot be read from the currently retained material.
Required materials and conditions: Missingness/dropout by arm, exclusion reasons, imputed values, ITT/PP and sensitivity analyses
Materials to obtain first: Missingness/dropout by arm, exclusion reasons, imputed values, ITT/PP and sensitivity analyses
Further research: Acquire participant flow diagrams, analysis plans and sensitivity-analysis material.
Remaining uncertainty: Analysis losses, reasons and handling cannot be read from the currently retained material.
Conditions for verification: Verify actual losses/handling for the selected 900 mg/placebo arms or explain that they remain unverified within the current material.
Why this condition is needed: Original sample size alone cannot establish that no analysis losses occurred.
Application exceptions: Do not fill losses absent from the current summary with 0 or 100% completion.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N14 · Are randomization methods, concealment and baseline balance in the 7-arm controlled trial verified?

Current findings: The primary study is a 7-arm single-blind controlled trial with an unverified randomization method. A meta-analysis’s RCT title is not transferred as verification of the primary trial’s allocation procedures.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Arm composition and controlled/blinding labels exist, but actual allocation, concealment and balance remain unresolved.
Reason for missing information: Arm composition and controlled/blinding labels exist, but actual allocation, concealment and balance remain unresolved.
Required materials and conditions: Original random sequence, allocation concealment, arm composition, baseline tables and recruitment process
Materials to obtain first: Original random sequence, allocation concealment, arm composition, baseline tables and recruitment process
Further research: Retrieve original Methods, allocation and baseline data to examine design limitations for the selected contrast.
Remaining uncertainty: Arm composition and controlled/blinding labels exist, but actual allocation, concealment and balance remain unresolved.
Conditions for verification: Distinguish the 7-arm single-blind controlled-trial wording from unverified allocation/concealment/balance.
Why this condition is needed: Controlled-trial/review-RCT labels must not be inherited as adequate allocation in the primary trial.
Application exceptions: An unverified randomization method does not establish that the trial was nonrandomized.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02

N15 · Are the people blinded, placebo appearance and assessment blinding verified?

Current findings: Only the single-blind label is retained; whether participants, clinicians or testers were blinded, placebo matching and unblinding remain unverified.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Material is unavailable to establish actual implementation beyond the blinding label.
Reason for missing information: Material is unavailable to establish actual implementation beyond the blinding label.
Required materials and conditions: Who was blinded, placebo appearance, blinding assessment/unblinding and tester procedures
Materials to obtain first: Who was blinded, placebo appearance, blinding assessment/unblinding and tester procedures
Further research: Acquire the primary trial’s blinding Methods and placebo/measurement procedures.
Remaining uncertainty: Material is unavailable to establish actual implementation beyond the blinding label.
Conditions for verification: Distinguish original blinding wording from unverified people and actual procedures for each outcome.
Why this condition is needed: The single-blind label must not be read as resolving all performance/measurement bias.
Application exceptions: An objective endpoint does not erase unverified performance/concomitant-treatment differences or measurement procedures.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N16 · Are ITT/PP, adjustment, between-group contrasts and analytical models for the selected result verified?

Current findings: Only P<.005 for garlic arms including 900 mg versus placebo, with completion and ITT unverified, is retained. Exact analysis populations, adjustment, models and the selected contrast definition remain unverified.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Significance wording alone cannot determine allocation effects, adherence effects or adjusted between-group changes.
Reason for missing information: Significance wording alone cannot determine allocation effects, adherence effects or adjusted between-group changes.
Required materials and conditions: Original SAP, ITT/PP analysis populations, baseline adjustment, between-/within-group comparisons and multi-arm contrast definitions
Materials to obtain first: Original SAP, ITT/PP analysis populations, baseline adjustment, between-/within-group comparisons and multi-arm contrast definitions
Further research: Retrieve the selected results table and analysis plan/model to link contrasts, denominators and adjustment.
Remaining uncertainty: Significance wording alone cannot determine allocation effects, adherence effects or adjusted between-group changes.
Conditions for verification: Compare the absolute between-group effect of interest at 24 weeks with actual analytical definitions and unverified aspects.
Why this condition is needed: Without knowing which effect is estimated, the P value cannot be read as the selected absolute between-group effect.
Application exceptions: Do not arbitrarily fill the analysis as ITT or turn within-group improvement into an additional effect.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N17 · Are the attribution of P<.005 for each garlic arm versus placebo and the selected effect’s limitations distinguished?

Current findings: P<.005 for each garlic arm versus placebo, including 900 mg/day, is recorded. The selected absolute between-group difference and 95%CI remain unverified.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Significance wording is retained, but test/contrast, effect-size and multiple-comparison details cannot be established.
Reason for missing information: Significance wording is retained, but test/contrast, effect-size and multiple-comparison details cannot be established.
Required materials and conditions: Original 24-week results table, contrasts by arm, tests, multiple comparisons and effect definition
Materials to obtain first: Original 24-week results table, contrasts by arm, tests, multiple comparisons and effect definition
Further research: Acquire the original results table and handling of multiple arms in testing, linking only the selected contrast separately.
Remaining uncertainty: Significance wording is retained, but test/contrast, effect-size and multiple-comparison details cannot be established.
Conditions for verification: Attribute P<.005 to the original statement and show alongside it that the 900 mg absolute effect and CI remain unverified.
Why this condition is needed: P values and effect size/precision provide different information.
Application exceptions: Do not convert each dose arm’s P value into the selected absolute %p or CI, or pool them as identical effects.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N18 · Are the absolute 24-week HbA1c effect and 95%CI for the selected 900 mg tablet verified?

Current findings: The selected 900 mg absolute between-group %p, 95%CI and completed denominator remain unverified. Meta-analysis estimates of −0.50%p/−0.53%p are not established effects of the selected tablet.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: The selected absolute effect, CI and analytical definitions are missing, so effect size, precision and importance cannot be established.
Reason for missing information: The selected absolute effect, CI and analytical definitions are missing, so effect size, precision and importance cannot be established.
Required materials and conditions: Baseline/final/change HbA1c in the selected/placebo arms, absolute between-group %p, variance, 95%CI and evidence for an important difference
Materials to obtain first: Baseline/final/change HbA1c in the selected/placebo arms, absolute between-group %p, variance, 95%CI and evidence for an important difference
Further research: Retrieve the primary trial’s selected results table, variance and denominators. If unavailable, quantitative replication research needs prespecified outcome reporting.
Remaining uncertainty: The selected absolute effect, CI and analytical definitions are missing, so effect size, precision and importance cannot be established.
Conditions for verification: Link the selected 900 mg absolute effect, interval and evidence for importance, or leave them precisely unverified.
Why this condition is needed: Primary-trial counts, significance and pooled means cannot determine the selected effect’s size or adequacy.
Application exceptions: Do not calculate and fill missing effects or CIs from P values or meta-analysis WMDs for other formulations.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03

N19 · Can the primary trial’s prespecified 24-week HbA1c rank 1 outcome hierarchy and analysis plan be compared with actual reporting?

Current findings: A prespecified single rank 1 primary 24-week HbA1c endpoint in the primary trial is unverified, and the registration check is recorded as unable to verify. CRD42024628780 is a meta-analysis registration label.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: No direct comparison of the primary trial’s prespecified hierarchy, analysis plan or changes is available.
Reason for missing information: No direct comparison of the primary trial’s prespecified hierarchy, analysis plan or changes is available.
Required materials and conditions: Contemporaneous primary-trial registration versions, protocol, SAP, endpoints/times and multi-arm change history
Materials to obtain first: Contemporaneous primary-trial registration versions, protocol, SAP, endpoints/times and multi-arm change history
Further research: Retrieve contemporaneous registration, protocol and SAP to compare the prespecified hierarchy for 24-week HbA1c and the selected 900 mg contrast.
Remaining uncertainty: No direct comparison of the primary trial’s prespecified hierarchy, analysis plan or changes is available.
Conditions for verification: Explicitly state that a prespecified single rank 1 primary endpoint is unverified and registration/SAP were not compared, separating review registration.
Why this condition is needed: Comparing prespecified plans with reports is needed to examine favorable selection of endpoints, times or arms.
Application exceptions: Unable to verify registration does not establish nonregistration; do not use review PROSPERO as a primary-trial NCT.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02

N20 · Is material available to distinguish the pooled HbA1c value from 3 trials and 7 effects from the selected tablet’s effect?

Current findings: HbA1c in the first meta-analysis involves 3 trials and 7 effects, with WMD −0.50%p (95%CI −0.66~−0.33). Mixed formulations and background treatments mean this is not an established effect of the selected tablet.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Pooled reported values/scale exist, but product, population, background-treatment and shared-control matching by effect remain unresolved.
Reason for missing information: Pooled reported values/scale exist, but product, population, background-treatment and shared-control matching by effect remain unresolved.
Required materials and conditions: HbA1c included trials, formulations/doses, populations, background treatments, times and effect/shared-control tables in the first meta-analysis
Materials to obtain first: HbA1c included trials, formulations/doses, populations, background treatments, times and effect/shared-control tables in the first meta-analysis
Further research: Retrieve included-trial tables and original results to link exposure, timing and shared controls for each HbA1c effect.
Remaining uncertainty: Pooled reported values/scale exist, but product, population, background-treatment and shared-control matching by effect remain unresolved.
Conditions for verification: Explain the reported WMD/CI, roles of 3 trials and 7 effects, mixed formulations/background treatments and indirectness for the selected effect.
Why this condition is needed: Multi-arm effects from the same trial and varied formulations/concomitant treatments must not be pooled as the selected 900 mg effect.
Application exceptions: Do not substitute 7 independent trials for 3 trials and 7 effects.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02

N21 · Is the overall scale of 27 RCTs and 1,619 participants across all endpoints distinguished from the HbA1c analysis scale?

Current findings: The second meta-analysis records 27 RCTs and 1,619 participants across all endpoints, with HbA1c WMD −0.53%p (95%CI −0.86~−0.20). Replication counts for the selected formulation and HbA1c analysis n remain unverified.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Overall scale and a reported HbA1c mean exist, but endpoint-/formulation-specific denominators and matching for the selected question remain unresolved.
Reason for missing information: Overall scale and a reported HbA1c mean exist, but endpoint-/formulation-specific denominators and matching for the selected question remain unresolved.
Required materials and conditions: Endpoint-specific trials/participants, products, populations, times, background treatments and HbA1c analysis tables in the second meta-analysis
Materials to obtain first: Endpoint-specific trials/participants, products, populations, times, background treatments and HbA1c analysis tables in the second meta-analysis
Further research: Retrieve endpoint-specific included-trial/effect tables, products and durations to separate the relevant HbA1c analysis.
Remaining uncertainty: Overall scale and a reported HbA1c mean exist, but endpoint-/formulation-specific denominators and matching for the selected question remain unresolved.
Conditions for verification: Preserve overall scale and HbA1c WMD/CI separately, marking endpoint-specific denominators and directness unverified.
Why this condition is needed: Reading all-endpoint scale as the sample size for HbA1c or the selected 900 mg comparison overstates precision.
Application exceptions: The 27 RCTs and 1,619 participants describe all endpoints; do not transfer them as unique HbA1c analysis n.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S03

N22 · Are included-trial and unique-participant overlaps between the primary trial and the two reviews verified?

Current findings: The original retained summary has no trial-family or included-trial/participant overlap table. Overlap between the primary trial and both reviews, and independent replications of the selected 900 mg, are unresolved.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: The existence of same/different reports is known, but material is unavailable to establish included-trial and unique-participant relationships.
Reason for missing information: The existence of same/different reports is known, but material is unavailable to establish included-trial and unique-participant relationships.
Required materials and conditions: Included-trial tables for both reviews, primary/multi-arm reports, registration numbers, recruitment sites/periods and unique-participant links
Materials to obtain first: Included-trial tables for both reviews, primary/multi-arm reports, registration numbers, recruitment sites/periods and unique-participant links
Further research: First construct a report-family table, comparing recruitment periods, sites and registrations to verify overlap.
Remaining uncertainty: The existence of same/different reports is known, but material is unavailable to establish included-trial and unique-participant relationships.
Conditions for verification: Explain the verified scope of primary-trial inclusion, overlap between reviews and unique-study/participant counts.
Why this condition is needed: Different reviews citing the same primary trial do not add independent replication evidence.
Application exceptions: Different bibliographic DOIs for reviews alone do not establish independent included trials/participants.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03

N23 · Are the scope and causes of I²96.4% and a positive publication-bias test in the first meta-analysis verified?

Current findings: The first meta-analysis records I²=96.4% and a positive publication-bias test. Test methods, effect distributions, missing results and causes remain unverified in the retained summary.
Verification status: Partly verified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Heterogeneity and test labels exist, but causes, test scope and missing results were not directly compared.
Reason for missing information: Heterogeneity and test labels exist, but causes, test scope and missing results were not directly compared.
Required materials and conditions: HbA1c effect distributions, I²/variance, heterogeneity/bias-test methods, prespecified hypotheses and missing results
Materials to obtain first: HbA1c effect distributions, I²/variance, heterogeneity/bias-test methods, prespecified hypotheses and missing results
Further research: Retrieve original forest plots, tests and formulation/background-treatment/time-specific results to review explanations for heterogeneity.
Remaining uncertainty: Heterogeneity and test labels exist, but causes, test scope and missing results were not directly compared.
Conditions for verification: Link reported heterogeneity, the positive test and unverified methods/causes to limitations in applying results to the selected formulation.
Why this condition is needed: The positive pooled mean and extreme heterogeneity must both be retained.
Application exceptions: A positive test alone must not generate a missing-trial count or corrected effect, or invalidate all trials.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S02

N24 · Have −0.50%p and −0.53%p been kept from being forced into the same analysis or an actual conflict?

Current findings: Retain the first meta-analysis’s −0.50%p/CI−0.66~−0.33 and the second’s −0.53%p/CI−0.86~−0.20 separately. Retain the second’s conclusion that additional high-quality RCTs are needed.
Verification status: Met
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Verification is limited to separately retaining each reported value and limitation; it does not establish homogeneity, independence or efficacy of the reviews.
Reason for missing information: Verification is limited to separately retaining each reported value and limitation; it does not establish homogeneity, independence or efficacy of the reviews.
Required materials and conditions: Results/CIs, analysis scope, products/background treatments and endpoint-specific inclusion differences between the two reviews
Materials to obtain first: Results/CIs, analysis scope, products/background treatments and endpoint-specific inclusion differences between the two reviews
Further research: Compare analytical scopes/included trials before separately reviewing whether an actual conflict concerns the same question.
Remaining uncertainty: Verification is limited to separately retaining each reported value and limitation; it does not establish homogeneity, independence or efficacy of the reviews.
Conditions for verification: Attribute both original reported values/CIs, heterogeneity and the need for additional high-quality RCTs to their respective sources without combining them.
Why this condition is needed: Differences between means with different analytical scopes must neither be ignored nor declared conflicts about the same question.
Application exceptions: Differences between review estimates alone do not establish conflicting data, equivalence or an effect of 0.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S02 S03

N25 · Are an optimal 900 mg dose, persistence after stopping and effects in specific subgroups verified?

Current findings: A 7-arm primary trial and a dose-response meta-analysis title exist, but direct results for optimality of 900 mg, maintenance after stopping and prespecified subgroup interactions remain unverified.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Direct results supporting extensions beyond the current selected 24-week HbA1c scope were not verified.
Reason for missing information: Direct results supporting extensions beyond the current selected 24-week HbA1c scope were not verified.
Required materials and conditions: Direct dose contrasts, cessation/long-term follow-up, prespecified subgroups, interactions and separate estimates
Materials to obtain first: Direct dose contrasts, cessation/long-term follow-up, prespecified subgroups, interactions and separate estimates
Further research: Claims of an optimal dose, maintenance or subgroups require product-fixed direct contrasts and prespecified subgroup/follow-up studies.
Remaining uncertainty: Direct results supporting extensions beyond the current selected 24-week HbA1c scope were not verified.
Conditions for verification: Distinguish the 7-arm/review dose-response labels from unverified direct extension results for 900 mg.
Why this condition is needed: The selected 24-week result must not be extended to an optimal dose, long-term maintenance or effects in special populations.
Application exceptions: Do not require all extension research as mandatory for the current narrow 24-week HbA1c question.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S03

N26 · Has an HbA1c difference been kept from being extended to replacing diabetes medication or preventing complications?

Current findings: Fasting glucose, HOMA-IR and lipids are kept separate from the selected HbA1c endpoint; results cannot be extended to replacing diabetes medication, preventing complications or identical effects from all garlic foods.
Verification status: Met
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Verification concerns explicit interpretive boundaries; it does not judge an absence of clinical-event effects or safety of replacement treatment.
Reason for missing information: Verification concerns explicit interpretive boundaries; it does not judge an absence of clinical-event effects or safety of replacement treatment.
Required materials and conditions: Original boundaries between the HbA1c surrogate and questions about medication replacement, complications and events
Materials to obtain first: Original boundaries between the HbA1c surrogate and questions about medication replacement, complications and events
Further research: Separate claims of replacement treatment or complication prevention require direct comparisons/event data for those clinical questions.
Remaining uncertainty: Verification concerns explicit interpretive boundaries; it does not judge an absence of clinical-event effects or safety of replacement treatment.
Conditions for verification: Explicitly prohibit extensions to medication replacement, complications and effects from all garlic foods.
Why this condition is needed: A surrogate-marker change does not automatically answer questions about other treatments or clinical events.
Application exceptions: Do not require event trials as mandatory to verify the numerical HbA1c question.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03

N27 · Are funding, product provision and conflicts of interest for the primary trial and both reviews actually verified?

Current findings: Primary-trial funding/product provision are unverified; the two meta-analyses are recorded as academic research with mixed original-trial funding. Original I1 is historical and is not new independence certification.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Specific funding, provision, author employment/patents, declared COI and independent-institution relationships are unresolved.
Reason for missing information: Specific funding, provision, author employment/patents, declared COI and independent-institution relationships are unresolved.
Required materials and conditions: Funding, product provision, author employment/patents, declared COI and institutional/independent-family relationships by report
Materials to obtain first: Funding, product provision, author employment/patents, declared COI and institutional/independent-family relationships by report
Further research: Retrieve funding, provision, COI, author and institutional information separately for primary papers/reviews, recording the actual scope.
Remaining uncertainty: Specific funding, provision, author employment/patents, declared COI and independent-institution relationships are unresolved.
Conditions for verification: Separate unverified primary-trial funding/product provision from the reviews’ wording of academic research and mixed primary-trial funding.
Why this condition is needed: Unverified funding must not be credited as independent funding or absence of conflicts.
Application exceptions: Do not inherit an academic-research label or original I1 as independent funding or replication certification.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03

N28 · Are hypoglycemic, gastrointestinal and bleeding events and collection methods for the selected formulation verified?

Current findings: The original caution concerns monitoring hypoglycemia with glucose-lowering medication, gastrointestinal discomfort, bleeding risk and content variation. Actual primary-trial event definitions/collection, occurrence by arm, severity and stopping remain unverified.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Cautions are retained, but actual collection/counting is unverified, so no events or safety cannot be asserted.
Reason for missing information: Cautions are retained, but actual collection/counting is unverified, so no events or safety cannot be asserted.
Required materials and conditions: Event definitions, active/spontaneous collection, severity, events/stopping by arm and missingness/dropout
Materials to obtain first: Event definitions, active/spontaneous collection, severity, events/stopping by arm and missingness/dropout
Further research: Acquire primary-trial AE, stopping and collection tables; review safety questions separately with suitable harm designs.
Remaining uncertainty: Cautions are retained, but actual collection/counting is unverified, so no events or safety cannot be asserted.
Conditions for verification: Separate caution wording from actual events/collection and the boundaries between not reported and not read.
Why this condition is needed: General caution wording must not become actual primary-trial adverse-event counts or absence of harm.
Application exceptions: Unverified harm data do not delete HbA1c reports; record separate states.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N29 · Are harm timing, denominators, follow-up and comparative risks in the selected two arms verified?

Current findings: Nominal 24 weeks, a description of 210 participants and 30 per arm exist, but harm occurrence/recovery, stopping/re-exposure, event denominators by arm, actual follow-up and comparative risks remain unverified.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Efficacy scale/duration cannot establish harm frequency or comparative risk.
Reason for missing information: Efficacy scale/duration cannot establish harm frequency or comparative risk.
Required materials and conditions: Exposure/events, stopping/recovery times, exposed people/people with events/event counts by arm, follow-up time and comparative estimates
Materials to obtain first: Exposure/events, stopping/recovery times, exposed people/people with events/event counts by arm, follow-up time and comparative estimates
Further research: Retrieve original arm-specific AE/stopping/exposure-time tables; long-term and rare harms need suitable follow-up data.
Remaining uncertainty: Efficacy scale/duration cannot establish harm frequency or comparative risk.
Conditions for verification: Link reporting of actual harm timing, controls, denominators/duration to currently unverified information.
Why this condition is needed: The scale of 210 participants/30 per arm and the 24-week schedule must not automatically become harm incidence or causal denominators.
Application exceptions: Do not calculate harm risk from efficacy times/sample sizes or extrapolate background rates.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N30 · Are glucose-lowering medication, baseline disease, other exposures and alternative explanations for harms reviewed?

Current findings: A caution to monitor hypoglycemia with glucose-lowering medication exists, but actual common medication is unverified, and baseline risks/other exposures and alternative event explanations by arm are unavailable.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Without actual event/co-exposure data, caution wording cannot be extended to a causal-risk estimate.
Reason for missing information: Without actual event/co-exposure data, caution wording cannot be extended to a causal-risk estimate.
Required materials and conditions: Concomitant medication by arm, baseline hypoglycemia/bleeding/disease, other exposures, changes and alternatives/adjustment
Materials to obtain first: Concomitant medication by arm, baseline hypoglycemia/bleeding/disease, other exposures, changes and alternatives/adjustment
Further research: Link original concomitant-medication, baseline and event records to review alternative explanations for harm and temporal relationships.
Remaining uncertainty: Without actual event/co-exposure data, caution wording cannot be extended to a causal-risk estimate.
Conditions for verification: Distinguish the warning context from the verified scope of actual co-exposure, underlying disease and alternatives.
Why this condition is needed: A concomitant-use caution alone must not attribute actual events solely to garlic.
Application exceptions: Missing alternative-explanation information does not establish that no other causes existed.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01

N31 · Is the scope of other independent harm records, long-term/rare risks and vulnerable groups verified?

Current findings: Harm-family tables, repeated events and direct long-term/rare-event/vulnerable-group data are not verified in the current 3 reports. The original caution does not certify overall safety.
Verification status: Unverified
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Efficacy reports and pooled means alone cannot verify independent harm replications or long-term/vulnerable-group safety.
Reason for missing information: Efficacy reports and pooled means alone cannot verify independent harm replications or long-term/vulnerable-group safety.
Required materials and conditions: Unique harm families, regulatory reports versus recitations, long-term/rare events, special-population exposure and interactions
Materials to obtain first: Unique harm families, regulatory reports versus recitations, long-term/rare events, special-population exposure and interactions
Further research: Review separate harm questions through unique-event links and suitable long-term follow-up/registration data.
Remaining uncertainty: Efficacy reports and pooled means alone cannot verify independent harm replications or long-term/vulnerable-group safety.
Conditions for verification: Separate direct harm replications and unverified long-term/vulnerable-group information from original efficacy material.
Why this condition is needed: Short-term efficacy trials/reviews must not be promoted to independent harm replications or overall safety.
Application exceptions: Do not require every rare-harm study for the current HbA1c question or add together repeated citations of the same event.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03

N32 · Are positive signals, the unverified selected effect and cautions explained at distinct levels?

Current findings: Positive P values/heterogeneous meta-analysis directions exist, but the selected 900 mg absolute effect, denominator and prespecified hierarchy remain unverified; safety retains the original Caution. Do not extend this to medication replacement or individual intake instructions.
Verification status: Met
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Verification concerns currently supportable wording and limits on extension; it is not new certification of efficacy, causality or safety.
Reason for missing information: Verification concerns currently supportable wording and limits on extension; it is not new certification of efficacy, causality or safety.
Required materials and conditions: Boundaries between P/pooled direction, selected quantitative gaps, original cautions and incidence/causality/individual prescribing
Materials to obtain first: Boundaries between P/pooled direction, selected quantitative gaps, original cautions and incidence/causality/individual prescribing
Further research: Revisit each question/row if actual quantitative or harm data are added; retain original boundaries until then.
Remaining uncertainty: Verification concerns currently supportable wording and limits on extension; it is not new certification of efficacy, causality or safety.
Conditions for verification: Retain positive statements alongside unverified selected effects/harms, explicitly explaining limits on causal/incidence extensions.
Why this condition is needed: Positive efficacy signals must not become safety, medication replacement or an established selected quantitative effect.
Application exceptions: Do not revise uncertainty and caution into a new safety grade or individual intake instructions.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03

N33 · Are the original 2026-09-08 reference date, 09-14 correction history, generic English wording and current scope distinguished?

Current findings: The original verdict-review date is 2026-09-08, with a 09-14 history of correcting 3 English-placeholder fields. Current generic-principle wording in English evidence/citations remains exactly as recorded; this conversion is not specific numerical verification, a new search or a correction.
Verification status: Met
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Verification concerns preservation of original dates, history, current values and work scope. Specific replacements in the English correction history were neither reconstructed nor certified; current publication/retraction status was not queried.
Reason for missing information: Verification concerns preservation of original dates, history, current values and work scope. Specific replacements in the English correction history were neither reconstructed nor certified; current publication/retraction status was not queried.
Required materials and conditions: Original verdict-review date, corrections, original Korean/English/evidence/citation fields and current reading/search/publication-status scope
Materials to obtain first: Original verdict-review date, corrections, original Korean/English/evidence/citation fields and current reading/search/publication-status scope
Further research: If original-data correction/evidence updating is separately requested, preserve the whole original and handle original locations/version changes as an event.
Remaining uncertainty: Verification concerns preservation of original dates, history, current values and work scope. Specific replacements in the English correction history were neither reconstructed nor certified; current publication/retraction status was not queried.
Conditions for verification: Link original dates, corrections/English wording and actual reading of the retained summary to the absence of searching/external reading; do not label no response as 0 studies.
Why this condition is needed: Historical access/correction labels must not be backdated into full-text reading, a current search or specific English verification in this conversion.
Application exceptions: Preserve original generic English principles; no translation correction or historical reconstruction is performed in this conversion.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03

N34 · Have original C46, Caution, all axes and empty subclaims been kept from being inherited as new condition states/grades?

Current findings: Original C46, Caution, B/S/R1/I1/EX/B1/CX, booleans/empty strings, subclaims=[] and bilingual synthesis/corrections are preserved unchanged. Row states are not new efficacy grades or recalculations of the original score.
Verification status: Met
Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted.
Why unverified: Verification concerns preservation of original verdict history, types and boundaries; existing verification labels are not inherited as independent clinical certification in this conversion.
Reason for missing information: Verification concerns preservation of original verdict history, types and boundaries; existing verification labels are not inherited as independent clinical certification in this conversion.
Required materials and conditions: Original typed grade/score/safety, bilingual synthesis/grade decisions, axes, corrections and empty subclaims
Materials to obtain first: Original typed grade/score/safety, bilingual synthesis/grade decisions, axes, corrections and empty subclaims
Further research: Correcting the original verdict requires a separate request and version/change event. It is not rescoring in this sheet conversion.
Remaining uncertainty: Verification concerns preservation of original verdict history, types and boundaries; existing verification labels are not inherited as independent clinical certification in this conversion.
Conditions for verification: Link original values/types unchanged, explaining that no new score/grade or subclaim index is generated.
Why this condition is needed: Conversion-table states preserve information by condition and must not automatically recalculate the original efficacy verdict.
Application exceptions: Do not display original verification labels or C46 as independent clinical certification, a new efficacy score or a condition-fulfillment rate.
Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application.

Related sources S01 S02 S03