{
  "schema_version": "chamgap-public-criteria-1.0",
  "title": "Lotus leaf tea or defined lotus leaf infusion × Reduction of systolic blood pressure in adults with hypertension",
  "language": "en",
  "translation_date": "2026-10-28",
  "criteria_version": "1.0",
  "criteria_date": "2026-10-05",
  "condition_origin": "Chamgap's own application conditions",
  "method_sources": [
    {
      "id": "M03",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03",
      "section": "§3.1, §3.2.1–3.2.3, MECIR C5/C7/C13",
      "official_principle": "Clearly record the question, eligibility conditions and reasons for changes; distinguish intervention variants.",
      "review_level": "Retained method-application records were reused. External originals were not reread and method content was not reassessed."
    },
    {
      "id": "M04",
      "version": "Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04",
      "section": "§4.5, §4.6.1–4.6.3, MECIR C42",
      "official_principle": "Link studies and reports separately; do not omit studies solely because results are unreported.",
      "review_level": "Retained method-application records were reused. External originals were not reread and method content was not reassessed."
    },
    {
      "id": "M08",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08",
      "section": "§8.1–8.2.3, Table 8.2.a",
      "official_principle": "Fix the result and effect of interest when examining randomization, deviations, missingness, measurement and selective reporting.",
      "review_level": "Retained method-application records were reused. External originals were not reread and method content was not reassessed."
    },
    {
      "id": "M15",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15",
      "section": "§15.2.4, §15.3.1–15.3.3",
      "official_principle": "Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.",
      "review_level": "Retained method-application records were reused. External originals were not reread and method content was not reassessed."
    },
    {
      "id": "M19",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19",
      "section": "§19.1.2, §19.2.1–19.2.4",
      "official_principle": "Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence.",
      "review_level": "Retained method-application records were reused. External originals were not reread and method content was not reassessed."
    }
  ],
  "status_dictionary": {
    "Met": "The narrow record, identity attribution or action specified by the question is verified. Do not automatically extend this to direct efficacy, precision or safety certification.",
    "Partly verified": "Some actual information required by the question is verified, but funding, identity, search scope or other verification remains incomplete.",
    "Unverified": "The actual facts/material required by the question cannot be established from retained material. This does not mean an effect of 0, worldwide research absence or failed access.",
    "Not reported": "Limited to the explicit material/section actually read. Do not newly assign this status to an entire unread paper.",
    "Conflicting data": "Used when reports of the same actual fact disagree. Different endpoints or interpretation of an original absence flag are not automatically regraded as conflicting data.",
    "Not applicable": "Used only with a specific reason for an extension obligation outside the actual scope of the current independent question. It does not replace unverified direct material or unread external material.",
    "Inaccessible": "Used only for an actual failed-access event. Do not assign it to external access not attempted in this work.",
    "Review incomplete": "Limited to the scope of external original-material comparisons not yet performed. Do not retrospectively mark completed local-summary content reading as incomplete."
  },
  "requirements": [
    {
      "item_id": "N01",
      "question_type": "Evidence condition",
      "question": "Which original claim and boundaries does this table convert?",
      "needed": "Canonical claim, plant part, route, population, endpoint, exclusions and original record locations",
      "role": "Required",
      "role_reason": "Needed to avoid combining body-fat, mechanistic or other plant-part effects solely because the plant name is the same.",
      "application_exception": "Korean and English describe the same claim. The original subclaim list is empty; do not create absent subclaims.",
      "criterion": "Connect the systolic-blood-pressure claim to a comparative question about single lotus leaf tea or a defined hot-water infusion in adults with hypertension; exclude other endpoints and plant parts.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "If the manuscript boundary changes, preserve the whole previous manuscript and compare the independent question again."
    },
    {
      "item_id": "N02",
      "question_type": "Evidence condition",
      "question": "Can an actual controlled human blood-pressure trial matching this boundary be identified?",
      "needed": "Trial report and identity matching the exact plant part, formulation, population, blood-pressure endpoint and comparator",
      "role": "Required",
      "role_reason": "Needed to avoid treating the existence of a related human body-fat trial as the existence of a direct blood-pressure comparison.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify the identity and design of a report in which adults with hypertension actually drank single lotus leaf tea or infusion and systolic blood pressure was compared with a concurrent control.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "In subsequent material selection, compare each report with this eligibility boundary and retain exclusion reasons."
    },
    {
      "item_id": "N03",
      "question_type": "Evidence condition",
      "question": "Can the botanical identity and leaf history of the actual blood-pressure trial product be verified?",
      "needed": "Botanical identification, plant part, batch, cultivar, origin and harvest records for the direct-trial product",
      "role": "Required",
      "role_reason": "Needed to avoid exchanging lotus plumules, seeds, roots or different leaf conditions for the same exposure.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify Nelumbo nucifera leaf identification, cultivar, origin and harvest timing, or equivalent product traceability, for the actual trial.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare product specifications with the trial report and distinguish leaf identity from unverified history."
    },
    {
      "item_id": "N04",
      "question_type": "Evidence condition",
      "question": "What formulation and manufacturing conditions were actually consumed in the blood-pressure trial?",
      "needed": "Manufacturing specifications, infusion conditions, batch testing and full ingredient list for the direct blood-pressure trial",
      "role": "Required",
      "role_reason": "Needed to avoid treating similarly named teas, capsules and extract test beverages as the same exposure.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify raw-material quantity, extraction/infusion procedure, composition or batch standardization, and mixed ingredients for the actual single tea or hot-water infusion.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare the trial formulation with the drinking boundary and record differences from ordinary tea, capsules and combination products."
    },
    {
      "item_id": "N05",
      "question_type": "Evidence condition",
      "question": "Are dose and drinking schedule in a direct blood-pressure trial verified?",
      "needed": "Raw-material/extract quantity, beverage volume, frequency and consumption records for the direct trial",
      "role": "Required",
      "role_reason": "Needed to avoid inheriting the body-fat trial’s 1–2 g and 400 mL as a hypertension treatment dose.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Connect raw-material/extract mass, beverage volume/frequency and actual daily amount to the blood-pressure trial; distinguish amounts provided from amounts consumed.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Verify trial-specific units and manufacturing yield, then distinguish nominal quantity from actual consumption."
    },
    {
      "item_id": "N06",
      "question_type": "Evidence condition",
      "question": "Are exposure duration and assessment times in a direct blood-pressure trial verified?",
      "needed": "Exposure schedule, blood-pressure visits and observations after discontinuation for the direct trial",
      "role": "Required",
      "role_reason": "Needed to avoid filling blood-pressure observation duration with another endpoint’s trial duration or traditional-use duration.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Connect start/end dates, blood-pressure assessment visits and actual exposure duration to the comparison.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare visits with drinking records and separate effects during treatment from persistence after stopping."
    },
    {
      "item_id": "N07",
      "question_type": "Evidence condition",
      "question": "Can actual hypertension participants’ selection and baseline status be verified?",
      "needed": "Diagnostic criteria, baseline characteristics, selection/exclusion table and group-specific blood pressure for the direct trial",
      "role": "Required",
      "role_reason": "Needed to avoid relabeling overweight completers as hypertension patients or extending results unchanged to general adults.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Connect diagnostic criteria, baseline blood pressure, age, severity, inclusion/exclusion, baseline treatment and distributions by group to the direct trial.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare recruitment and baseline tables to distinguish the hypertension population in the question from other populations."
    },
    {
      "item_id": "N08",
      "question_type": "Evidence condition",
      "question": "Can oral consumption and actual adherence in a direct trial be verified?",
      "needed": "Route, consumption, returned-product, adherence and other lotus-product use records for the direct trial",
      "role": "Required",
      "role_reason": "Needed to distinguish in vitro or intravenous animal results from oral drinking and avoid automatically equating supplied beverage with actual intake.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify actual route, frequency, adherence, contamination or crossover consumption of the trial product.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare exposure records with result timing and separately retain gaps in adherence information."
    },
    {
      "item_id": "N09",
      "question_type": "Evidence condition",
      "question": "Is the actual comparator in a direct blood-pressure comparison verified?",
      "needed": "Control beverage, ingredients, intake schedule and common-treatment specifications for the direct trial",
      "role": "Required",
      "role_reason": "Needed to avoid converting uncontrolled or mechanistic material into a between-group comparison or recording an intended placebo as an actual placebo.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify the actual control beverage, placebo or usual-care group’s ingredients, intake, common management and differences between groups.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Separate actual differences in the comparison and examine what can be attributed to single lotus-leaf consumption."
    },
    {
      "item_id": "N10",
      "question_type": "Evidence condition",
      "question": "Are the comparative design and allocation procedures of a direct blood-pressure trial verified?",
      "needed": "Original design, allocation, concealment and baseline-comparison material for the direct trial",
      "role": "Required",
      "role_reason": "A related report’s use of the word trial does not establish the design for the direct question.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify parallel/crossover design, randomized/nonrandomized allocation, concealment and baseline comparison for the actual result.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare design/allocation information for each result and retain unverified designs as unverified."
    },
    {
      "item_id": "N11",
      "question_type": "Evidence condition",
      "question": "Can antihypertensive treatment, lifestyle and rescue-treatment changes be separated from the drinking contribution?",
      "needed": "Group-specific concomitant medication, adjustments, lifestyle, rescue treatment, adherence and analytical handling",
      "role": "Required",
      "role_reason": "Needed to avoid attributing differences in concurrent management affecting blood pressure to lotus leaf tea.",
      "application_exception": "Do not require every change to be identical between groups. Match the actual effect of interest and analysis; distinguish interaction-data gaps from absent efficacy.",
      "criterion": "Verify baseline antihypertensives, medication adjustments, rescue treatment, diet/exercise changes and actual analytical handling by group.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare concomitant treatment over time with the effect of interest to distinguish common management from drinking differences."
    },
    {
      "item_id": "N12",
      "question_type": "Evidence condition",
      "question": "Can systolic-blood-pressure measurement conditions in a direct trial be verified?",
      "needed": "Direct blood-pressure measurement manual, devices, visits, repetitions and blinding material",
      "role": "Required",
      "role_reason": "Needed to avoid converting body-fat percentage or enzyme inhibition into blood-pressure values and to distinguish measurement differences from actual change.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify office or 24-hour measurement, device, posture, repetitions/averaging, time of day, assessor and the same procedure between groups.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare measurement procedures with result tables and attribute office and 24-hour results separately."
    },
    {
      "item_id": "N13",
      "question_type": "Evidence condition",
      "question": "Are blood-pressure units, final values or changes, and assessment visits verified?",
      "needed": "Direct blood-pressure result table, units, baseline/end values, visits and change definitions",
      "role": "Required",
      "role_reason": "Needed to avoid turning the presence of an endpoint name into reported actual blood-pressure figures.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Connect systolic-blood-pressure units, final value/change, visit and analytical direction for direct results to the original table.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Connect original-table result definitions with comparator and time; do not mix figures from other endpoints."
    },
    {
      "item_id": "N14",
      "question_type": "Evidence condition",
      "question": "Are allocation, measurement and analysis denominators in a direct blood-pressure trial verified?",
      "needed": "Group-specific flowchart and blood-pressure measurement/analysis denominators for the direct trial",
      "role": "Required",
      "role_reason": "Needed to avoid inheriting 95 and 60 from another endpoint as direct blood-pressure analysis counts.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Distinguish allocation, exposure, blood-pressure measurement and analysis counts by group; connect each denominator with its actual result.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare the flow from allocation to blood-pressure analysis and distinguish the role of each denominator."
    },
    {
      "item_id": "N15",
      "question_type": "Evidence condition",
      "question": "Can missingness, withdrawals and their handling in a direct blood-pressure analysis be verified?",
      "needed": "Direct blood-pressure trial flowchart, withdrawal reasons, missing-data handling and sensitivity analyses",
      "role": "Required",
      "role_reason": "Needed to avoid judging follow-up completeness or missing-data bias in a direct trial solely from the word completers.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify missing blood-pressure observations, discontinuation/withdrawal reasons, group differences and analysis inclusion, imputation and sensitivity handling.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare reasons for missing blood-pressure observations with analysis inclusion; do not estimate an unknown magnitude of bias."
    },
    {
      "item_id": "N16",
      "question_type": "Evidence condition",
      "question": "Is the between-group effect estimated by a direct blood-pressure analysis verified?",
      "needed": "Analysis population, model, effect of interest and between-group result table for the direct trial",
      "role": "Required",
      "role_reason": "Needed to avoid importing uncontrolled changes or another endpoint’s analysis as a between-group blood-pressure effect of lotus leaf tea.",
      "application_exception": "A valid unadjusted between-group analysis may suit the design and effect of interest. Verifying a formal effect does not always require covariate adjustment.",
      "criterion": "Verify assignment/adherence effects, ITT/PP or other analysis populations, between-/within-group distinctions and a valid analytical model.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare the analysis plan with original results to identify an estimator appropriate for the effect of interest."
    },
    {
      "item_id": "N17",
      "question_type": "Evidence condition",
      "question": "Can a direct between-group blood-pressure estimate and uncertainty interval be verified?",
      "needed": "Direct between-group blood-pressure estimate, interval, variance definition, denominator and assessment time",
      "role": "Required",
      "role_reason": "Needed to avoid turning a failure to identify evidence into an effect of 0 or a sufficiently precise null difference.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Connect a reported between-group blood-pressure estimate, CI/SE/SD type, result denominator and assessment time to the original table.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare reported intervals and estimands with the original model; do not calculate absent values to fill gaps."
    },
    {
      "item_id": "N18",
      "question_type": "Evidence condition",
      "question": "Are the evidence and criteria for judging the importance of a blood-pressure change verified?",
      "needed": "Direct blood-pressure effect/interval and a clearly sourced important difference or application criterion",
      "role": "Required",
      "role_reason": "Needed to avoid declaring clinical sufficiency solely from significance or trial counts.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify material allowing the actually reported interval to be compared with a justified important difference and application context for the question.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare effect intervals with importance evidence without arbitrarily setting new thresholds or grades."
    },
    {
      "item_id": "N19",
      "question_type": "Evidence condition",
      "question": "Can the prespecified plan and actual report of a direct blood-pressure trial be compared?",
      "needed": "Registration, protocol, analysis plan, complete results and amendment reasons for the direct blood-pressure trial",
      "role": "Required",
      "role_reason": "Needed to avoid inheriting a related body-fat registration as a direct blood-pressure plan or declaring selective reporting without evidence.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Compare registration/protocol, analysis plan and reports for direct blood-pressure endpoints, times and analyses; verify reasons for changes.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare planned and reported endpoints/times; preserve unfavorable and null results as well."
    },
    {
      "item_id": "N20",
      "question_type": "Evidence condition",
      "question": "Is the same direct blood-pressure comparison verified in other independent study families?",
      "needed": "Direct blood-pressure trial family identities, registration, institutions, populations and result-link table",
      "role": "Required",
      "role_reason": "Needed to avoid turning report counts or mechanistic studies into independent replications of direct efficacy.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify eligible-family populations, drinking exposures, blood-pressure outcomes, comparators, times and report links to distinguish replication from recitation.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare eligibility by family; do not count reports/registration from the same trial more than once."
    },
    {
      "item_id": "N21",
      "question_type": "Evidence condition",
      "question": "Was the Ye body-fat report retained separately from direct blood-pressure efficacy?",
      "needed": "Ye report title, population, body-fat endpoint, formulation, exclusion reason and original locations",
      "role": "Required",
      "role_reason": "Needed to retain related human material without upgrading effects outside the question into direct evidence.",
      "application_exception": "Successful record separation does not satisfy the direct-comparison requirement. Direct blood-pressure material remains unverified in N02 and the other actual-data questions.",
      "criterion": "Preserve both the related formulation and the exclusion reason based on mismatched population, effect and endpoint.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "When related reports are added, compare matching and mismatched aspects of the question separately."
    },
    {
      "item_id": "N22",
      "question_type": "Evidence condition",
      "question": "Were Ye’s 95 and 60 retained in their original denominator roles?",
      "needed": "Ye’s original denominator description and population/endpoint locations",
      "role": "Required",
      "role_reason": "Needed to avoid converting allocation counts into analysis counts or denominators for other results.",
      "application_exception": "Do not newly calculate withdrawal counts, rates or causes from the difference between 95 and 60. Do not infer absent flowcharts or hypertension subgroups.",
      "criterion": "Retain allocation of 95 and analysis of 60 overweight completers as distinct body-fat report denominators; do not use them as direct blood-pressure analysis n.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "If further flowchart and analysis material is obtained, compare each denominator’s role without synthesizing a new withdrawal rate."
    },
    {
      "item_id": "N23",
      "question_type": "Evidence condition",
      "question": "Is equivalence between the body-fat test beverage and hypertension-targeted lotus leaf tea verified?",
      "needed": "Manufacture, composition, raw-material/extract quantity and intake for both formulations, plus direct blood-pressure population data",
      "role": "Required",
      "role_reason": "A similar-formulation description does not prove the same product or exposure.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify manufacture, composition, exposure and application to a direct population for the 1–2 g hot-water extract/400 mL test beverage and the selected tea/infusion.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare formulation and exposure equivalence using material; retain unverified application to ordinary tea."
    },
    {
      "item_id": "N24",
      "question_type": "Evidence condition",
      "question": "Was in vitro ACE material retained separately from human blood-pressure results?",
      "needed": "In vitro design, participant description, enzyme endpoint and exclusion reason",
      "role": "Required",
      "role_reason": "Needed to avoid mixing the existence of a mechanism with a human treatment effect.",
      "application_exception": "No human participants is a design fact about this in vitro study. It does not mean 0 human lotus-related studies worldwide.",
      "criterion": "Retain the actual context of plant-part in vitro enzyme inhibition with no human participants; do not convert it into clinical blood-pressure figures.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Connect mechanistic and clinical material by result type; examine human effect direction and magnitude using separate direct material."
    },
    {
      "item_id": "N25",
      "question_type": "Evidence condition",
      "question": "To what extent are funding and author interests in the related reports verified?",
      "needed": "Study-funding, product-provision, employment, patent and conflict-of-interest sections for each report",
      "role": "Supplementary; required for interpreting independence",
      "role_reason": "Needed to avoid treating academic classification as proof of independent funding or industry support as automatic invalidation.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify actual study funding, product provision, employment, patents and interest disclosures in each report’s original material. Specify the funding/independence scope; category descriptions alone remain partial information.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare funding and interest sections report by report; examine direct blood-pressure trial independence separately."
    },
    {
      "item_id": "N26",
      "question_type": "Evidence condition",
      "question": "Can harm collection, discontinuations and denominators for the same population and drink be verified?",
      "needed": "AE definitions, collection, exposure/follow-up, denominators and discontinuation data for the same population/formulation",
      "role": "Supplementary; required for interpreting harms/safety",
      "role_reason": "Needed to avoid turning unverified direct efficacy or absent harm figures into safety or 0 events.",
      "application_exception": "This table asks about blood-pressure comparisons. Harm material is not always mandatory for efficacy, but the gap must remain when making safety claims.",
      "criterion": "Verify actual exposure, follow-up, event definitions, collection, discontinuations, denominators by group and harm records in adults with hypertension.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Examine efficacy and harm results separately; compare collection scope and missingness."
    },
    {
      "item_id": "N27",
      "question_type": "Evidence condition",
      "question": "Are direct data available for vulnerable populations and concomitant-drug interactions?",
      "needed": "Population-specific exposure, baseline risk, concomitant medicines, interactions and follow-up material",
      "role": "Supplementary; required for safety interpretation in the corresponding population/concomitant use",
      "role_reason": "Needed to avoid treating single oral tea as proof of safety across all populations and drug combinations.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify actual populations, exposures and outcomes for pregnancy, lactation, liver/kidney disease and concomitant antihypertensive/glucose-lowering medicines.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Examine special populations and concomitant use with separate eligibility; do not extrapolate from general participants."
    },
    {
      "item_id": "N28",
      "question_type": "Evidence condition",
      "question": "Is cardiovascular-event prevention assessed as a mandatory endpoint in this blood-pressure table?",
      "needed": "Direct event, comparator, follow-up and denominator data if an extension claim is made",
      "role": "Supplementary; required for clinical-event extensions",
      "role_reason": "Needed to distinguish a numerical-change question from event-prevention or medication-replacement questions.",
      "application_exception": "Do not always require event material. Not applicable is limited to the current extension scope; it does not establish absent event effects or safety.",
      "criterion": "When the selected claim is limited to systolic-blood-pressure comparison, treat event prevention as a separate direct claim rather than an always-mandatory blood-pressure endpoint.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "If an event extension is requested, examine a separate independent boundary and required material."
    },
    {
      "item_id": "N29",
      "question_type": "Evidence condition",
      "question": "Does this table establish an optimal dose or persistence after discontinuation?",
      "needed": "Direct dose comparisons, post-discontinuation follow-up and prespecified subgroup material if an extension is claimed",
      "role": "Supplementary; required for dose/persistence extensions",
      "role_reason": "Needed to avoid confusing unverified main-trial dose with unrequested optimal-dose/persistence claims.",
      "application_exception": "Do not remove the need for actual main-trial dose/duration. Do not create arbitrary minimum-dose, duration or subgroup obligations.",
      "criterion": "If the original claim does not include dose optimization or post-discontinuation comparisons, do not add those judgments. Actual main-trial dose and duration remain separately required.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Examine direct comparisons and follow-up within a new independent boundary for each extension question."
    },
    {
      "item_id": "N30",
      "question_type": "Evidence condition",
      "question": "Were retained summaries actually read distinguished from external-material reading status?",
      "needed": "Actual reading scope, original locations, file fingerprints and reading history for each material",
      "role": "Required",
      "role_reason": "Needed to avoid treating the presence of a URL, PMID, PMCID or NCT as successful reading of external full text.",
      "application_exception": "External access not attempted does not mean inaccessible. Summary-read badges refer only to exact retained locations and file fingerprints.",
      "criterion": "Separate actual reading of the retained summary from unattempted/unread external bibliography, abstracts, full papers and registration for each material.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "If access is actually performed, record a separate event, date and acquired scope, then update the badge."
    },
    {
      "item_id": "N31",
      "question_type": "Evidence condition",
      "question": "Are historical reading levels and actual access dates of original materials verified report by report?",
      "needed": "Report-specific original-material access, acquisition, reading level, actual dates and material-type records",
      "role": "Required",
      "role_reason": "Needed to avoid issuing current or historical full-text reading status solely from dates or bibliography links.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify each original material’s access level/date or actual access log; distinguish them from global review and correction dates.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "When original access history is added, compare the included document’s history separately from its underlying original materials."
    },
    {
      "item_id": "N32",
      "question_type": "Evidence condition",
      "question": "To what extent are the scope and currency of the retained search record verified?",
      "needed": "Original search dates, strings, result lists, selection/exclusion records and registration-check scope",
      "role": "Required",
      "role_reason": "Needed to avoid expanding one search-record sentence into a complete current literature review or proof of worldwide research absence.",
      "application_exception": "Do not fill facts unverified in the retained material with evidence about other lotus parts, formulations, populations or endpoints. Unverified material does not prove an effect of 0 or the worldwide absence of research.",
      "criterion": "Verify original search dates, complete search strings, result lists and selection/exclusion procedures to reproduce the search for directly eligible comparisons. Databases and partial keywords alone require distinguishing verified parts from gaps.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "In subsequent updates, preserve search/selection histories separately and limit absence wording to checked scope and dates."
    },
    {
      "item_id": "N33",
      "question_type": "Evidence condition",
      "question": "Were the original ?, unrecorded values and human-study absence flag distinguished from related human material?",
      "needed": "Original grade, score, axes, related human evidence, direct boundary and locations of absence wording",
      "role": "Required",
      "role_reason": "Needed to retain the original status without interpreting an absence flag as worldwide human-evidence absence or an effect of 0.",
      "application_exception": "Do not import absent evidence-status, editorial-review, material-list, study-family or evidence-cutoff fields from adjacent cases. Retain absent, unrecorded, false and empty-list states separately.",
      "criterion": "Retain the original grade ?, unrecorded score/axes and true human-study absence flag; separately explain the related human body-fat trial and unverified direct blood-pressure material.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "If the manuscript is corrected, retain whole before/after versions and event reasons; distinguish verdict changes from changes in table attribution."
    },
    {
      "item_id": "N34",
      "question_type": "Evidence condition",
      "question": "Were the English correction event and unchanged original-verdict scope retained?",
      "needed": "Before/after correction versions, change areas, event date and unchanged-grade record",
      "role": "Required",
      "role_reason": "Needed to avoid converting a translation/wording correction into new clinical evidence or verdict validation.",
      "application_exception": "If the whole historical pre-correction manuscript is absent from this input, do not claim new access/comparison. This concerns retention of the original correction record.",
      "criterion": "Connect the original record of the 2026-09-14 correction of 16 English evidence-table fields with retention of grade, score, citations and verdict date without new research or regrading.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "For later corrections, retain the whole original and record wording, added evidence and verdict changes as separate events."
    },
    {
      "item_id": "N35",
      "question_type": "Evidence condition",
      "question": "Can the related reports’ identifiers and study-family links actually be verified?",
      "needed": "Original-paper/registration identity comparisons and actual study-family/result links for each report",
      "role": "Required",
      "role_reason": "Needed to avoid counting related reports, registration and bibliography entries as independent blood-pressure trials or new participant families.",
      "application_exception": "S01/S02 are local bibliography-array tracking IDs, not original material-ID keys. Do not create new original-material collections from absent native material/study-family lists.",
      "criterion": "Compare actual report title, PMID, DOI, PMCID and NCT identities and study/endpoint links against original papers/registration. Local identifiers alone remain partial information with the uncompared scope explicit.",
      "basis": "Existing method principles distinguish population, plant part, manufacture, drinking exposure, comparator, timing, denominators, missingness, measurement, between-group effects, intervals, plans, study families, funding and harms. Detailed conditions are Chamgap’s own application.",
      "condition_origin": "These conditions for lotus leaf tea/hot-water infusion and systolic blood pressure in adults with hypertension were developed with knowledge of the retained content and frozen before application. This does not establish clinical preregistration, blinded development, official-method certification or independent clinical validation.",
      "proposed_research": "Compare identifiers and originals; update same/different/unknown relationships only to the established level."
    }
  ]
}