{
  "schema_version": "chamgap-public-evidence-check-1.0",
  "public_id": "v3099-main",
  "verdict_number": "3099",
  "title": "Oral single-active-ingredient pantothenic acid (vitamin B5) supplementation × Reduction in inflammatory lesion counts in adults with mild-to-moderate facial acne",
  "view_version": "1.0",
  "view_created_date": "2026-11-02",
  "criteria_version": "NGM-v3099-ORAL-SINGLE-B5-ACNE-INFLAMMATORY-1.0",
  "criteria_date": "2026-10-05",
  "review_date": "2026-10-05",
  "legacy_evidence_date": "2026-09-15",
  "review_scope": {
    "materials_read": "Archived Korean and English manuscripts and case-specific condition and application records",
    "clinical_papers_directly_read": false,
    "new_clinical_search": false,
    "limitation": "No external clinical abstracts, full texts, registrations, or analysis plans were newly read. Historical access records are distinguished from the reading of archived summaries in this review. Original judgments, numerical values, and unverified matters were preserved, with no new searches, calculations, or reassessment.",
    "date_meaning": "This is the date the archived material was checked, not the date of a search for the latest clinical literature."
  },
  "claim_context": {
    "population": "Adults with mild-to-moderate facial acne; distinguished from efficacy in correcting deficiency",
    "intervention": "Pantothenic acid (vitamin B5) as the sole active ingredient; the calcium salt requires separate verification · Oral · Oral formulation with a single active ingredient — exact salt, tablet/capsule, and release formulation unverified",
    "dose": "Unverified — the directly eligible monotherapy dose could not be verified",
    "comparator": "Placebo with the same background treatment — detailed composition of the actual single-active-ingredient comparison is unverified",
    "endpoint": "Between-group difference in change in inflammatory lesion counts; the endpoint difference is reported separately, and eligible numerical results are unverified",
    "duration": "Unverified — the assessment time point for directly eligible monotherapy is unverified",
    "excluded_extensions": [
      "Calcium pantothenate and the free acid are not automatically treated as equivalent; dexpanthenol and topical/intramuscular material are kept within the boundaries of adjacent evidence.",
      "The legacy 028 or reference files are not labeled as directly read in this review, and their clinical numerical values are not inherited.",
      "Unverified actual doses and assessment time points for the single-active-ingredient product remain under the separate required conditions N10/N11 and are not erased by this Not applicable status."
    ]
  },
  "requirements": [
    {
      "item_id": "N01",
      "question_type": "Separate claim",
      "question": "Which single question is linked to the original verdict URL?",
      "needed": "The current assessment target, facets, empty subclaims, canonical URL, and identity of the related 028.",
      "role": "Required",
      "role_reason": "Required to avoid merging other skin effects or the existing mixed claim 028 into the efficacy of the single ingredient assessed here.",
      "application_exception": "Korean/English versions and adjacent outcomes such as total lesions do not automatically generate separate independent claims.",
      "criterion": "Link the original /ko/effect to adult facial acne, oral pantothenic acid as the sole active ingredient, inflammatory lesion counts, and a placebo comparison with the same background treatment.",
      "basis": "Question-clarification principles in M03 §3.1, §3.2.1–3.2.4; detailed separation rules are internally designed — internal adaptation for a separate claim. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Before incorporating new material, use an inclusion/exclusion table to compare the assessment target with the population, intervention, and endpoint of each result.",
      "current_reports": [
        "S01",
        "S03",
        "S04"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The current /ko/effect is a reduction in inflammatory lesion counts in adults with mild-to-moderate facial acne. subclaims is an empty array, and the related 028 is linked as a historical mixed claim. This table covers the original main question alone.",
      "condition_status": "Met",
      "status_reason": "The current claim, subclaim structure, and original verdict identity were linked to the actual preserved archived summaries. This is separate from verification of efficacy.",
      "missingness": "The eligible single-active-ingredient formulation, dose, duration, and between-group numerical results remain unverified under subsequent conditions.",
      "uncertainty": "The existence of other skin outcomes cannot replace the current question about inflammatory lesions.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "The current assessment target, facets, empty subclaims, canonical URL, and identity of the related 028."
    },
    {
      "item_id": "N02",
      "question_type": "Sole active ingredient",
      "question": "Was the effect of pantothenic acid alone distinguished from the product effect?",
      "needed": "Material documenting all active ingredients, the exact salt, actual route, product, and batch of the single-active-ingredient formulation.",
      "role": "Required",
      "role_reason": "The presence of an ingredient alone cannot establish its isolated effect.",
      "application_exception": "Calcium pantothenate and the free acid are not automatically treated as equivalent; dexpanthenol and topical/intramuscular material are kept within the boundaries of adjacent evidence.",
      "criterion": "Verify whether the exact active ingredient, molecule, and route match the fixed question, and separate results from combination products.",
      "basis": "M03 §3.2.2–3.2.3; reverse-direction labeling and adaptation for tests are internally designed; question-clarification principles in M03 §3.1, §3.2.1–3.2.4; detailed separation rules are internally designed — internal adaptation for a sole active ingredient. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Code each trial's intervention in a table of ingredients, salts, routes, and concurrent ingredients, and first assess direct comparability.",
      "current_reports": [
        "S01",
        "S03",
        "S04",
        "S06",
        "S10",
        "S11"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The question concerns oral pantothenic acid as the sole active ingredient. The current manuscript could not verify that the 2014 Pantothen product had a sole active ingredient, and keeps calcium pantothenate in a separate verification stratum. Topical, intramuscular, and NAD mechanism material is not used as evidence of the effect of oral monotherapy.",
      "condition_status": "Unverified",
      "status_reason": "The question boundaries are clear, but the actual identity of the directly eligible single-active-ingredient intervention has not been verified.",
      "missingness": "The exact chemical form and complete active composition of the single-active-ingredient formulation are unverified.",
      "uncertainty": "The words pantothenic acid in a title or a brand name do not guarantee sole-active-ingredient status or equivalence of a batch.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Material documenting all active ingredients, the exact salt, actual route, product, and batch of the single-active-ingredient formulation."
    },
    {
      "item_id": "N03",
      "question_type": "Level of reading",
      "question": "Was summary reading in this review distinguished from historical access to original texts?",
      "needed": "The preserved URL, location, and access_level for each citation, and any records of individual access dates/acquired copies, if available.",
      "role": "Required",
      "role_reason": "Required to avoid mistaking an external link or historical full_text for full-text reading in this review.",
      "application_exception": "Because the original citation has no access date, leave the value empty and record the global verified_date separately as the material review date.",
      "criterion": "Separate the currently archived summaries actually read, each report's historical access_level, external access not attempted/material not read in this review, and the absence of access dates.",
      "basis": "Material collection/selection principles in M04 §4.5–4.6; separation of access and reading and the hyperlink contract are internally designed; M04 §4.5, §4.6.3; limitations on the current material conversion reflect the user's scope and internal design — internal adaptation for the level of reading. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "For each actual acquisition event, record document type, bytes, verification location, and access/reading times separately, and compare them with the summary reader.",
      "current_reports": [
        "S01",
        "S02",
        "S03",
        "S04",
        "S05",
        "S06",
        "S09",
        "S10",
        "S11"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The currently preserved KO/EN text, evidence, and bibliography were actually read. The historical full_text for S01/S04/S06, the full-document PDF for S02, full_text_mirror for S03, metadata_search_index for S05, and inherited_local_record for S09–S11 are preserved unchanged. Access to all external original texts was not attempted, and none were acquired or read in this review.",
      "condition_status": "Met",
      "status_reason": "Current summary reading and the historical access level of each material were recorded separately. This does not mean that external full-text verification is complete.",
      "missingness": "Actual access dates for individual citations and current external bytes are unavailable. The historical source ledger and old 028 files were also not read in this review.",
      "uncertainty": "The original global review date 2026-09-15 is not converted into individual access dates or successful external access on 2026-10-05.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "The preserved URL, location, and access_level for each citation, and any records of individual access dates/acquired copies, if available."
    },
    {
      "item_id": "N04",
      "question_type": "Report and trial families",
      "question": "Were the Yang main text and supplementary slide kept from being double-counted as trials?",
      "needed": "Each report's DOI, year, trial identity, supplementary-material linkage, and original evidence family_id.",
      "role": "Required",
      "role_reason": "Required to avoid adding a paper and its appendix as independent replications or assuming that materials from different years of the same brand concern an identical batch.",
      "application_exception": "S03 is the original F02 uncontrolled material from 2012. Even with the same Pantothen brand, batch identity with S01 is unverified.",
      "criterion": "Link S01/S02 to the same 2014 Yang family, and distinguish the original F01–F04 labels from a count of independent trials.",
      "basis": "Distinction between studies and reports in M04 §4.6.1–4.6.2; cohort/outcome linkage is an internal application — internal adaptation for report and trial families. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Group related reports in a trial-identity table and compare titles, DOI, duration, populations, and batches to identify duplication and unestablished matters.",
      "current_reports": [
        "S01",
        "S02",
        "S03",
        "S04",
        "S05"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The S01 main text and S02 single-page summary slide belong to the same Yang 2014 material set. The original evidence labels them S01 F01, S03 F02, S04 F03, and S05 F04. These labels are not newly added up as unique eligible trials, independent replications, or a participant total.",
      "condition_status": "Partly verified",
      "status_reason": "The linkage between the same paper and its appendix is verified, but the independent identities and duplication of all studies have not been exhaustively verified.",
      "missingness": "Detailed original family/selection ledgers and cross-checks of all registrations and batches remain outstanding.",
      "uncertainty": "The count of 9 reports does not mean 9 clinical trials or 9 independent replications.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Each report's DOI, year, trial identity, supplementary-material linkage, and original evidence family_id."
    },
    {
      "item_id": "N05",
      "question_type": "Population and selection",
      "question": "Does the material directly match adults with mild-to-moderate facial acne?",
      "needed": "Tables of diagnosis, age/severity distributions, inclusion/exclusion, and baseline treatment in single-active-ingredient trials.",
      "role": "Required",
      "role_reason": "The label facial acne alone does not establish that populations and clinical selection are the same.",
      "application_exception": "The phrase mild-to-moderate facial acne in the title of an adjacent study is not extended into verification of all actual population details.",
      "criterion": "Compare diagnosis, age, severity, lesion location, inclusion/exclusion, and the actual directly eligible population.",
      "basis": "M03 §3.2.1; detailed population criteria are internally designed — internal adaptation for population and selection. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Prepare an eligibility table by diagnosis, severity, and baseline treatment to review differences between the original target population and study populations.",
      "current_reports": [
        "S01",
        "S03"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original target population is adults with mild-to-moderate facial acne. Yang/Capodice are related facial-acne studies, but sole-active-ingredient product status and actual population details have not been established as currently directly eligible evidence.",
      "condition_status": "Unverified",
      "status_reason": "The current facets define the target population for the question, but information on selection and representativeness of an eligible single-active-ingredient population is unverified.",
      "missingness": "Actual diagnostic criteria, age groups, severity, and exclusion criteria for the single-active-ingredient trial remain outstanding.",
      "uncertainty": "The inclusion of adults in the question is not generalized into effects in children, other body areas, or severe acne.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Tables of diagnosis, age/severity distributions, inclusion/exclusion, and baseline treatment in single-active-ingredient trials."
    },
    {
      "item_id": "N06",
      "question_type": "Deficiency boundary",
      "question": "Was the hypothesis of deficiency correction distinguished from efficacy for acne in general?",
      "needed": "Baseline nutritional status, methods of identifying deficiency, and direct comparative results within that stratum.",
      "role": "Supplementary; required for extension to deficiency",
      "role_reason": "Required to avoid transferring a deficiency hypothesis to efficacy in an unverified general acne population.",
      "application_exception": "Unverified baseline status is not filled in as normal or deficient. The S05 hypothesis is not a single-active-ingredient RCT with results.",
      "criterion": "Distinguish baseline pantothenic acid status, deficiency diagnosis, and correction outcomes from a comparison of monotherapy for acne.",
      "basis": "M03 §3.2.1; detailed population criteria are internally designed; question-clarification principles in M03 §3.1, §3.2.1–3.2.4; detailed separation rules are internally designed — internal adaptation for the deficiency boundary. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Separate deficient and nondeficient strata only in studies with baseline-status data, and compare whether effect modification was prespecified.",
      "current_reports": [
        "S05"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original facets explicitly distinguish this from efficacy in correcting deficiency. Leung 1995 is a bibliographic lead for a deficiency hypothesis and related reports; directly eligible between-group results for inflammatory lesions are unverified.",
      "condition_status": "Unverified",
      "status_reason": "The deficiency boundary was preserved, but the actual population's baseline status or effects by deficiency status have not been verified.",
      "missingness": "Baseline deficiency identification, proportions, and stratum-specific comparative results are unavailable.",
      "uncertainty": "This table does not newly establish the hypothesis that deficiency causes acne or that supplementation is necessary.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Baseline nutritional status, methods of identifying deficiency, and direct comparative results within that stratum."
    },
    {
      "item_id": "N07",
      "question_type": "Salt, batch, and quality",
      "question": "Were the salt, formulation, and manufacturing batch of the eligible single-active-ingredient product verified?",
      "needed": "Trial-batch manufacturing/composition certificates, complete label, salt and labeled-amount basis, and formulation-quality data.",
      "role": "Required",
      "role_reason": "Product names and labeled amounts alone cannot establish the actual sole active ingredient or exposure.",
      "application_exception": "The efficacy and doses of the calcium salt and free acid are not converted as equivalent. The presence of excipients alone does not establish that a product has multiple active ingredients.",
      "criterion": "Link the exact salt, manufacturing source, purity, batch, release formulation, and tablet/capsule to the actual trial product.",
      "basis": "M03 §3.2.2–3.2.3; reverse-direction labeling and adaptation for tests are internally designed — internal adaptation for salt, batch, and quality. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Separate the salt, active-amount basis, excipients, and purity in batch records, and compare the trial intervention with the label for agreement.",
      "current_reports": [
        "S01",
        "S03",
        "S06"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The manufacturing source, exact salt, brand, purity, batch, release formulation, and medication adherence for the current single-active-ingredient product are unverified. Calcium pantothenate was retained as a separate search stratum, and equal effects with the free acid were not assumed.",
      "condition_status": "Unverified",
      "status_reason": "The formulation identity left unverified in the manuscript cannot be filled in as actual manufacturing certification.",
      "missingness": "Actual chemical-form and quality/batch data for the directly eligible single-active-ingredient product are needed.",
      "uncertainty": "Molecular names or routes in other papers are not corrected on the basis of terminology alone or merged as the same product.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Trial-batch manufacturing/composition certificates, complete label, salt and labeled-amount basis, and formulation-quality data."
    },
    {
      "item_id": "N08",
      "question_type": "2014 product composition",
      "question": "Can the sole-active-ingredient status of the 2014 Pantothen product be verified?",
      "needed": "The complete active composition, exact salt, and batch certificate for the 2014 batch, and comparator ingredients.",
      "role": "Required",
      "role_reason": "Required to avoid accepting the product effect in a related RCT as the effect of the selected ingredient alone.",
      "application_exception": "The fact that the 2012 product had multiple ingredients does not establish that the 2014 batch was identical.",
      "criterion": "Verify all active ingredients in the relevant 2014 trial batch and assess whether its effect can be separately attributed to B5.",
      "basis": "M03 §3.2.2–3.2.3; reverse-direction labeling and adaptation for tests are internally designed; M03 §3.2.3, M08 §8.2.2–8.2.3; internal application — internal adaptation for 2014 product composition. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Compare the 2014 batch composition with a placebo under the same background treatment, and review whether a comparison isolates the single ingredient.",
      "current_reports": [
        "S01",
        "S02",
        "S03"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "Yang 2014 is a 12-week study of Pantothen. There is a report that 4 tablets contain pantothenic acid 2.2 g, but the complete active composition, exact salt, and trial-batch certificate are currently unverified. An identical batch to the same brand's 2012 composition was not assumed.",
      "condition_status": "Unverified",
      "status_reason": "The amount of pantothenic acid contained and verification that it is the sole active ingredient are different conditions, and the latter is not met.",
      "missingness": "The complete composition and evidence of sole-active-ingredient status for the relevant year and trial batch remain outstanding.",
      "uncertainty": "The single-page summary slide in S02 does not substitute for a composition certificate or protocol.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "The complete active composition, exact salt, and batch certificate for the 2014 batch, and comparator ingredients."
    },
    {
      "item_id": "N09",
      "question_type": "2012 combination product",
      "question": "Were the other ingredients and dosing of the 2012 product distinguished?",
      "needed": "The complete active composition, amounts/units of each ingredient, dosing records, and product-batch data for 2012.",
      "role": "Required (attribution of related material)",
      "role_reason": "Required to avoid repurposing within-group results for a combination product as comparative efficacy of pantothenic acid alone.",
      "application_exception": "Complete composition or unit extractions absent from the current archived summaries are not supplemented from old ledgers or the brand name.",
      "criterion": "Attribute the multiple ingredients, L-carnitine, and dosing frequency in 2012 and the 8-week observation to that product alone.",
      "basis": "M03 §3.2.2–3.2.3; reverse-direction labeling and adaptation for tests are internally designed; M03 §3.2.3, M08 §8.2.2–8.2.3; internal application — internal adaptation for the 2012 combination product. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Reconstruct a table of actual amounts and dosing frequency by ingredient, leave unverified composition empty, and assess the possibility of an isolated comparison.",
      "current_reports": [
        "S03"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The 2012 Pantothen product is described as having multiple ingredients, including other vitamins and L-carnitine. The dosing was 2 tablets per administration, 2 times daily for 8 weeks, and the manuscript reports that the complete composition extraction and unverified units were left in a separate ledger. That ledger was not read in this review.",
      "condition_status": "Partly verified",
      "status_reason": "The preserved description of multiple ingredients, frequency, and duration was linked, but complete ingredient amounts and units were not verified.",
      "missingness": "The exact amount and unit of each active ingredient and the complete batch composition are unverified.",
      "uncertainty": "Material from a different year for the same brand is not counted as the identical intervention or an independent monotherapy replication.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "The complete active composition, amounts/units of each ingredient, dosing records, and product-batch data for 2012."
    },
    {
      "item_id": "N10",
      "question_type": "Labeled and actual amounts",
      "question": "Was the reported dose kept from being converted into a therapeutic dose for the single-active-ingredient product?",
      "needed": "Labeled-amount basis, frequency, actual use/adherence, diet, and other supplemental intake for the eligible single-active-ingredient product.",
      "role": "Required",
      "role_reason": "Required to avoid presenting the adjacent product's 2.2 g/day as a verified dose for acne treatment with the single ingredient alone.",
      "application_exception": "Salt conversions, actual intake, and optimal doses absent from the original material are not calculated.",
      "criterion": "Distinguish the product's reported amount from the actual active amount, adherence, and total intake for the single-active-ingredient product.",
      "basis": "M03 §3.2.2–3.2.3; reverse-direction labeling and adaptation for tests are internally designed; M03 §3.2.1–3.2.4; details on dose, duration, and effect modification are internally designed — internal adaptation for labeled and actual amounts. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "After reviewing adherence while separating labeled amounts from actual exposure, assess whether there are direct dose comparisons of the same formulation.",
      "current_reports": [
        "S01",
        "S03",
        "S06"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The reported amount for the 2014 product is 2.2 g/day, described as the content of 4 tablets. The manuscript does not use this as a verified therapeutic dose of B5 alone. The directly eligible monotherapy dose and actual adherence are unverified.",
      "condition_status": "Unverified",
      "status_reason": "A reported product amount is available, but verified actual exposure to a single-active-ingredient product matching the question is unavailable.",
      "missingness": "Actual active amounts, medication adherence, and other intake for the single-active-ingredient product are needed.",
      "uncertainty": "The adult nutritional reference of 5 mg/day and the NIH example of 10 g/day are not a basis for establishing a clinical dose.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Labeled-amount basis, frequency, actual use/adherence, diet, and other supplemental intake for the eligible single-active-ingredient product."
    },
    {
      "item_id": "N11",
      "question_type": "Duration and time points",
      "question": "Were product observation periods distinguished from eligible single-active-ingredient time points?",
      "needed": "Start/end dates, assessment schedules, duration of observation, and endpoint-specific timelines for the single-active-ingredient product.",
      "role": "Required",
      "role_reason": "Required to avoid combining adjacent comparisons of different durations into a direct effect at a single time point.",
      "application_exception": "S04's 2 months are not newly converted to 8 weeks, and nominal duration is not assumed to establish actual exposure or complete follow-up.",
      "criterion": "Attribute 12 weeks, 8 weeks, and 2 months to their respective reports, and keep treatment/assessment time points for the eligible single-active-ingredient product separate.",
      "basis": "M03 §3.2.2–3.2.3; reverse-direction labeling and adaptation for tests are internally designed; M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are internally designed; M03 §3.2.1–3.2.4; details on dose, duration, and effect modification are internally designed — internal adaptation for duration and time points. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Separate dosing, assessment, and analysis time points by report in a timeline, and review comparability of the same endpoint at the same time point.",
      "current_reports": [
        "S01",
        "S03",
        "S04"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "Yang 2014 is preserved as 12 weeks, Capodice 2012 as 8 weeks, and Saki 2025's separate intramuscular comparison as 2 months. The duration and assessment time point of directly eligible monotherapy are unverified in facets.",
      "condition_status": "Unverified",
      "status_reason": "The adjacent durations were read, but they cannot replace the single-active-ingredient time point in the original question.",
      "missingness": "Actual dosing duration, assessment time points, and continued follow-up for the eligible single-active-ingredient product are unavailable.",
      "uncertainty": "Differences in duration alone are not grounds for classification as conflicting information or no effect.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Start/end dates, assessment schedules, duration of observation, and endpoint-specific timelines for the single-active-ingredient product."
    },
    {
      "item_id": "N12",
      "question_type": "Placebo and background treatment",
      "question": "Was the difference between the single-active-ingredient product and placebo under the same background treatment verified?",
      "needed": "Complete composition of the single-active-ingredient product/placebo, common treatment by group, rescue treatment/changes, and adherence records.",
      "role": "Required",
      "role_reason": "Required to avoid attributing contributions from concurrent ingredients or other treatments to pantothenic acid alone.",
      "application_exception": "Compare the effect of interest and actual management in each group rather than requiring complete identity of all changes in both groups.",
      "criterion": "Separate placebo composition, concomitant/rescue treatment, adherence, and deviations from the difference in the sole active ingredient.",
      "basis": "M03 §3.2.2–3.2.3; reverse-direction labeling and adaptation for tests are internally designed; M03 §3.2.3, M08 §8.2.2–8.2.3; internal application — internal adaptation for placebo and background treatment. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Design a comparison of the single-active-ingredient product and a matching placebo under the same background treatment, and prespecify recording and analysis of changes in concomitant/rescue treatment.",
      "current_reports": [
        "S01",
        "S04"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original comparator is placebo under the same background treatment, but the detailed composition of the actual single-active-ingredient comparison is unverified. Yang is a related placebo-controlled product trial, while Saki's adapalene background is a comparison involving a different route.",
      "condition_status": "Unverified",
      "status_reason": "The design label placebo-controlled alone cannot verify sole-active-ingredient status or matching background conditions.",
      "missingness": "The complete placebo ingredients and group-specific concomitant/rescue treatment, adherence, and deviation data remain outstanding.",
      "uncertainty": "Even if background treatment for another route is verified, this does not establish the effect of oral monotherapy.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Complete composition of the single-active-ingredient product/placebo, common treatment by group, rescue treatment/changes, and adherence records."
    },
    {
      "item_id": "N13",
      "question_type": "Allocation and concealment",
      "question": "Were the actual allocation process and baseline balance verified?",
      "needed": "Random sequence, concealment, group-specific baseline tables, and original methods text for the direct single-active-ingredient comparison.",
      "role": "Required (causal efficacy)",
      "role_reason": "The labels randomized and double-blind alone cannot establish that all allocation and confounding problems were resolved.",
      "application_exception": "Preserve the uncontrolled S03 material as well, and do not automatically assign Not applicable for crossover/cluster design when the direct design is unverified.",
      "criterion": "Compare the allocation method, concealment, and baseline balance for the selected result separately from the study label.",
      "basis": "M08 §8.1–8.2.3; internal application — internal adaptation for allocation and concealment. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Compare the methods and baseline tables against outcome-specific allocation/concealment questions, and separate unverified elements.",
      "current_reports": [
        "S01",
        "S03"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "Yang's original design is a randomized, double-blind, placebo-controlled study lasting 12 weeks, and Capodice is an uncontrolled, open-label study lasting 8 weeks. The archived summaries read in this review contain no review of sequence generation, allocation concealment, or baseline balance for a directly eligible single-active-ingredient product.",
      "condition_status": "Unverified",
      "status_reason": "Design labels from related product trials were not upgraded into verification of methods for a single-active-ingredient comparison.",
      "missingness": "Allocation procedures, concealment, and baseline balance for the direct single-active-ingredient comparison are needed.",
      "uncertainty": "This table is not an official RoB 2 assessment or a definitive bias judgment.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Random sequence, concealment, group-specific baseline tables, and original methods text for the direct single-active-ingredient comparison."
    },
    {
      "item_id": "N14",
      "question_type": "Baseline means and SD",
      "question": "Were 15.3(8.9) and 17.3(14.3) kept from being used as effects?",
      "needed": "The baseline table's means/SDs, groups/time points, and denominators, and the endpoint/change results table for the outcome concerned.",
      "role": "Required (numerical attribution)",
      "role_reason": "Needed to avoid converting baseline lesion counts or parenthesized SDs into single-ingredient effects and precision values.",
      "application_exception": "Do not newly calculate endpoint differences, differences in change, or CI from baseline SDs and sample sizes.",
      "criterion": "Distinguish the baseline inflammatory-lesion means and SDs in Table 1 from endpoint values, differences in change, SE, and CI.",
      "basis": "M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are internally designed; M08 §8.1–8.2.3; internal application — internal adaptation for baseline means/SDs. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Cross-check each numerical value in the table by group, time point, and statistic, and extract baseline values separately from treatment results.",
      "current_reports": [
        "S01"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The retained text reports the baseline inflammatory-lesion mean (SD) in Table 1 as 15.3(8.9) for the product group and 17.3(14.3) for the placebo group. This is a baseline comparison, not a treatment effect, endpoint value, or CI.",
      "condition_status": "Met",
      "status_reason": "The original attribution to baseline, group, and mean/SD was preserved, and no new effect was calculated.",
      "missingness": "Inflammatory-lesion endpoint/change values and their variances, denominators, and intervals remain separately unverified.",
      "uncertainty": "The external Table 1 was not reread in this review; the values were transferred from the retained text.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "The baseline table's means/SDs, groups/time points, and denominators, and the endpoint/change results table for the outcome concerned."
    },
    {
      "item_id": "N15",
      "question_type": "Endpoint type",
      "question": "Were inflammatory lesions separated from total lesions and other assessments?",
      "needed": "Lesion classifications, counting definitions, the primary/secondary endpoint table, and between-group results for each endpoint.",
      "role": "Required",
      "role_reason": "Needed to avoid automatically substituting total-lesion results for the original inflammatory-lesion effect.",
      "application_exception": "Do not fill in values or priorities for other scales, such as IGA, that are absent from the currently archived summaries.",
      "criterion": "Separate the definitions/priorities of inflammatory-lesion counts, total lesions, noninflammatory lesions, and other clinical assessments.",
      "basis": "M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are internally designed; M08 Table 8.2.a, M03 §3.2.4; internal application — internal adaptation for endpoint types. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Specify inflammatory lesions as the prespecified endpoint of interest and report total lesions, noninflammatory lesions, and other scales as separate results.",
      "current_reports": [
        "S01"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "Yang's primary endpoint is total lesions, while inflammatory lesions and other endpoints are reported as secondary. The original question concerns the between-group difference in change in inflammatory-lesion counts; the endpoint difference is separate. Total-lesion results were not used as inflammatory-lesion results.",
      "condition_status": "Partly verified",
      "status_reason": "The difference in endpoints was verified, but the precise lesion classifications, measurement methods, and target results table remain to be verified.",
      "missingness": "Detailed comparison of inflammatory/noninflammatory counting definitions, other scales, and endpoint-specific results/hierarchy is unverified.",
      "uncertainty": "Additional scales such as IGA were not verified from the currently retained archived summaries, and significance for total lesions is not repurposed.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Lesion classifications, counting definitions, the primary/secondary endpoint table, and between-group results for each endpoint."
    },
    {
      "item_id": "N16",
      "question_type": "Counting and blinding",
      "question": "Can the actual procedures for lesion counting and assessor blinding be determined?",
      "needed": "Lesion-counting manual, assessor training/agreement, maintenance of blinding, and collection schedules by group.",
      "role": "Required",
      "role_reason": "Needed to avoid judging a measurement to be objective or a surrogate endpoint merely because it is called an observer count.",
      "application_exception": "Do not repurpose the double-blind designation as verification of actual lesion-assessor blinding or measurement limitations.",
      "criterion": "Verify inflammatory-lesion assessors, counting rules, assessment time points, blinding, and measurement differences between groups.",
      "basis": "M08 Table 8.2.a, M03 §3.2.4; internal application — internal adaptation for counting/blinding. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Review blinded assessment and agreement in advance using standardized counting procedures, and record differences in measurement schedules between groups.",
      "current_reports": [
        "S01"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The retained original assessment records that the lesions themselves are the treatment target and are not reclassified as surrogate markers merely because they are counted by an observer. Yang's design is described as double-blind, but details of lesion-counting procedures and assessor blinding are currently unverified.",
      "condition_status": "Unverified",
      "status_reason": "Endpoint classification and the design designation alone cannot substitute for verification of the actual measurement process.",
      "missingness": "The assessor's counting method, training/agreement, maintenance of blinding, and collection at identical time points are needed.",
      "uncertainty": "Insufficient measurement-procedure information does not mean an effect of 0 or confirmed measurement bias.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Lesion-counting manual, assessor training/agreement, maintenance of blinding, and collection schedules by group."
    },
    {
      "item_id": "N17",
      "question_type": "Allocation and evaluation denominators",
      "question": "Which analyses do 48/41 and the group-specific 20/21 counts belong to?",
      "needed": "Flow diagram, group-specific allocation/completion/analysis table, endpoint-specific analysis n, and group identification.",
      "role": "Required",
      "role_reason": "Needed to avoid immediately converting an evaluable sample into the target endpoint's ITT denominator or group-specific participants.",
      "application_exception": "Do not newly map the group-specific 20/21 order in the current n field to product/placebo without the original material.",
      "criterion": "Distinguish allocation, evaluation, and group-specific reported counts from the inflammatory-lesion analysis denominator, and do not infer group correspondence.",
      "basis": "M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are internally designed; M08 §8.2.2, M15 §15.3.1; internal application — internal adaptation for allocation/evaluation denominators. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Separate the flow table into allocation, completion, and target-endpoint analysis, and compare denominator links by group/time point.",
      "current_reports": [
        "S01"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "S01 reports 48 allocated and 41 evaluated, with group-specific counts of 20/21. The original what_research explicitly states that the endpoint-specific analysis denominator for inflammatory lesions could not be verified. No group assignment for 20/21 or ITT denominator was added from this n field alone.",
      "condition_status": "Partly verified",
      "status_reason": "The original allocation/evaluation counts were preserved, but endpoint-specific denominators, group correspondence, and analysis definitions remain to be verified.",
      "missingness": "The actual group-specific analysis n for inflammatory lesions and correspondence to each flow stage/group are unverified.",
      "uncertainty": "Do not calculate a new dropout rate, effect, or event rate from 48 and 41.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Flow diagram, group-specific allocation/completion/analysis table, endpoint-specific analysis n, and group identification."
    },
    {
      "item_id": "N18",
      "question_type": "Missing data and analysis populations",
      "question": "Were people who were not evaluated and the handling of ITT/PP verified?",
      "needed": "Reasons for loss to follow-up/discontinuation by group, ITT/PP definitions, missing-data handling, and sensitivity analyses.",
      "role": "Required",
      "role_reason": "Needed to avoid transferring selected evaluable results to an effect among everyone allocated.",
      "application_exception": "Do not arbitrarily assign ITT or PP if the original text does not specify the analysis.",
      "criterion": "Link reasons for missing data/discontinuation, their distribution by group, analysis populations, and imputation/sensitivity handling to the target endpoint.",
      "basis": "M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are internally designed; M08 §8.2.2, M15 §15.3.1; internal application — internal adaptation for missing data/analysis populations. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Distinguish interest in the effect of assignment from the effect of adherence, and compare analysis plans/sensitivity analyses that include missing endpoint data.",
      "current_reports": [
        "S01",
        "S03"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "S01's 48 allocated and 41 evaluated and S03's 11 enrolled and 10 completed are different data. The currently archived summaries did not verify group-specific reasons for missing inflammatory-lesion data or ITT/PP, imputation, and sensitivity handling.",
      "condition_status": "Unverified",
      "status_reason": "Only flow counts are available, without evidence on missing-data/analysis handling for the target outcome.",
      "missingness": "Group-specific reasons for attrition, missing inflammatory-endpoint data, analysis populations, and handling principles are needed.",
      "uncertainty": "Do not convert unverified information into 0 dropouts or confirmed selection bias.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Reasons for loss to follow-up/discontinuation by group, ITT/PP definitions, missing-data handling, and sensitivity analyses."
    },
    {
      "item_id": "N19",
      "question_type": "Target between-group effect",
      "question": "Are the between-group difference, P, and CI for inflammatory lesions with the single-ingredient intervention available?",
      "needed": "Results table for the directly relevant single-ingredient intervention, including endpoint/change means, variances, group-specific n, analysis model, P, and CI.",
      "role": "Required",
      "role_reason": "Needed to avoid filling the gap in single-ingredient inflammatory-lesion effects with numbers for total lesions or combination products.",
      "application_exception": "Do not calculate new effects or intervals by reconstructing graphs or using baseline SDs or other lesion counts.",
      "criterion": "Link the directly eligible single-ingredient intervention's between-group difference in inflammatory-lesion change, endpoint difference, P, CI, and denominators to the exact analysis.",
      "basis": "M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are internally designed; M08 §8.2.2, M15 §15.3.1; internal application; M15 §15.3.1–15.3.3; internal application — internal adaptation for the target between-group effect. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "In a single-ingredient intervention–placebo comparison with the same background treatment, report between-group estimates and intervals for the prespecified inflammatory endpoint by analysis population.",
      "current_reports": [
        "S01",
        "S02",
        "S03"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The current primary_effect records for mean_difference, confidence_interval, p_value, and analysis sample size are all empty. The manuscript records that an eligible controlled result for the single-ingredient intervention and exact inflammatory-lesion endpoint values, between-group differences in change, CI, P, and endpoint-specific n could not be verified.",
      "condition_status": "Unverified",
      "status_reason": "The empty values for the original target effect and analysis data were preserved as they were, without filling them with adjacent values.",
      "missingness": "Effect estimates, uncertainty, denominators, and analysis definitions for the target single-ingredient outcome are needed.",
      "uncertainty": "Empty values do not mean an effect of 0, nonsignificance, or equivalence.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Results table for the directly relevant single-ingredient intervention, including endpoint/change means, variances, group-specific n, analysis model, P, and CI."
    },
    {
      "item_id": "N20",
      "question_type": "Variance and intervals",
      "question": "Was precision kept from being filled in using baseline SDs or significance for other endpoints?",
      "needed": "Variances of inflammatory-lesion change/endpoint values, group-specific n, and SE/CI appropriate to the analysis.",
      "role": "Required",
      "role_reason": "Because the presence of sample sizes or baseline SDs alone cannot establish the precision of the target effect.",
      "application_exception": "Do not convert the existing empty axes.precision value into a score of 0, high precision, or a new interval.",
      "criterion": "Distinguish the target effect's variance/SE/CI from baseline means (SDs) and P for other endpoints.",
      "basis": "M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are internally designed; M15 §15.3.1–15.3.3; internal application — internal adaptation for variances/intervals. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Compare change-score variances and intervals appropriate to the original analysis, and record limitations imposed by missing-data assumptions on interval interpretation.",
      "current_reports": [
        "S01"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The Table 1 values 15.3(8.9) and 17.3(14.3) are baseline means (SDs). The direct-effect CI and SE are empty in the current calculation record, and the precision axis also retains its original empty value. No new interval was constructed from these values.",
      "condition_status": "Unverified",
      "status_reason": "Baseline variance and target-effect precision are separate, and the required direct interval is absent.",
      "missingness": "Endpoint-specific change/endpoint variances, SE, CI, and analysis denominators remain to be verified.",
      "uncertainty": "The total-lesion P=0.0197 does not signify adequate precision for the inflammatory-lesion result of the single-ingredient intervention.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Variances of inflammatory-lesion change/endpoint values, group-specific n, and SE/CI appropriate to the analysis."
    },
    {
      "item_id": "N21",
      "question_type": "Favorable total-lesion values",
      "question": "Were the outcomes and denominators to which P=0.0197 and 68.21% refer preserved?",
      "needed": "Original total-lesion results table, calculation formula/denominator for 68.21%, group/time point, and effect direction.",
      "role": "Required (preservation of related results)",
      "role_reason": "Needed to retain favorable adjacent results without repurposing them as single-ingredient inflammatory-lesion effects.",
      "application_exception": "Do not accept 68.21% as an additional reduction relative to placebo or an effect of pantothenic acid alone.",
      "criterion": "Attribute the total-lesion P and the 68.21% wording only to the original product/analysis, and indicate that the calculation formula and denominator are unverified.",
      "basis": "M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is internally designed; M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are internally designed; M08 §8.2.2, M15 §15.3.1; internal application — internal adaptation for favorable total-lesion values. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Compare the wording's formula, denominator, group, and endpoint with the original table, and verify from the original definition whether it represents an additional effect relative to placebo.",
      "current_reports": [
        "S01"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "Yang's total-lesion result P=0.0197 and the 68.21% wording were retained as originally reported. The formula and denominator for 68.21% are unclear, so it was not accepted as an additional reduction relative to placebo, and the total-lesion P was not assigned to inflammatory lesions.",
      "condition_status": "Partly verified",
      "status_reason": "The presence and limitations of the favorable values were verified, but their formula, denominator, and direct attribution remain to be verified.",
      "missingness": "The exact formula, comparison reference, and denominator for 68.21%, and the original endpoint-specific tables, are needed.",
      "uncertainty": "Do not newly calculate relative/absolute reduction percentages or the single ingredient's contribution.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Original total-lesion results table, calculation formula/denominator for 68.21%, group/time point, and effect direction."
    },
    {
      "item_id": "N22",
      "question_type": "Separating ingredient contributions",
      "question": "Can the contribution of B5 be separated from the combination product's effect?",
      "needed": "Full composition, ingredient-specific comparators or appropriate factorial comparisons, and common-background data.",
      "role": "Required",
      "role_reason": "Because a randomized product-level comparison does not automatically estimate a separately identified ingredient-level causal effect.",
      "application_exception": "Do not delete the product results as invalid; retain them as adjacent results for the original product.",
      "criterion": "Check whether there is a comparison in which other active ingredients and common treatments are held constant and only B5 differs.",
      "basis": "M03 §3.2.3, M08 §8.2.2–8.2.3; internal application; M03 §3.2.2–3.2.3; reverse-direction labeling and test adaptations are internally designed — internal adaptation for separating ingredient contributions. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Review a single-ingredient comparison in which only B5 differs, or a factorial design with ingredient contributions defined in advance.",
      "current_reports": [
        "S01",
        "S03"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The current manuscript distinguishes the effects of pantothenic acid alone from those of products containing pantothenic acid. The sole-active-ingredient status of the 2014 product is unverified, and the 2012 product has multiple ingredients. The separate contribution of B5 could not be verified from the results for both products.",
      "condition_status": "Unverified",
      "status_reason": "Product comparisons and within-group changes are available, but there are no data separating the contribution of the sole active ingredient.",
      "missingness": "A direct comparison in which only B5 differs, full active-ingredient composition, and identical background conditions are needed.",
      "uncertainty": "Do not interpret unverified composition as counterevidence showing that B5 has no effect.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Full composition, ingredient-specific comparators or appropriate factorial comparisons, and common-background data."
    },
    {
      "item_id": "N23",
      "question_type": "Uncontrolled within-group results",
      "question": "Was the 2012 change of 20.45→11.18 kept from being converted into a between-group effect?",
      "needed": "The 2012 results table, global-lesion definition, within-group analysis, flow of 11 enrolled/10 completed, and detailed composition.",
      "role": "Required (preservation of related results)",
      "role_reason": "Needed to distinguish improvement over time from additional improvement relative to a comparator.",
      "application_exception": "Do not newly calculate placebo effects, additional effects, or reduction percentages from within-group changes.",
      "criterion": "Attribute within-group changes in global lesions from an uncontrolled, open-label study to their separate product/endpoint/denominator.",
      "basis": "M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is internally designed; M08 §8.2.2, M15 §15.3.1; internal application — internal adaptation for uncontrolled within-group results. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Extract within-group results separately, and compare alternative explanations involving temporal change, regression, and concurrent treatment against comparative data.",
      "current_reports": [
        "S03"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "Capodice 2012 is an uncontrolled, open-label study over 8 weeks, with 11 enrolled and 10 completed as reported. The global-lesion change of 20.45→11.18 is a within-group change with a multi-ingredient product, not an inflammatory-lesion effect relative to placebo.",
      "condition_status": "Partly verified",
      "status_reason": "The original favorable within-group result was preserved, but the comparator, sole-active-ingredient status, and target endpoint differ from the original question.",
      "missingness": "A direct controlled comparison of the single-ingredient intervention and results for the target inflammatory-lesion outcome were not acquired.",
      "uncertainty": "Do not convert the limitation of no comparator into absence of results or invalidity of the study itself.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "The 2012 results table, global-lesion definition, within-group analysis, flow of 11 enrolled/10 completed, and detailed composition."
    },
    {
      "item_id": "N24",
      "question_type": "Other routes and no detected difference",
      "question": "Was Saki's P=0.476 kept from being used as an effect of 0 for oral single-ingredient supplementation?",
      "needed": "Saki's actual molecule/formulation, intramuscular administration, adapalene background, analysis groups/time points, and original results table.",
      "role": "Required (boundaries for contrary results)",
      "role_reason": "Needed to retain the related nonsignificant result without mistaking it for repeated counterevidence against oral pantothenic acid.",
      "application_exception": "Preserve the dexpanthenol description in the original KO and the Pantothenic Acid wording in the paper title; do not resolve molecular identity from the names alone.",
      "criterion": "Attribute the P for the endpoint-value comparison involving a different route, molecule, and background only to that analysis.",
      "basis": "M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is internally designed; M03 §3.2.2–3.2.3; reverse-direction labeling and test adaptations are internally designed; M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are internally designed — internal adaptation for other routes/no detected difference. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Compare differences in the reported title, actual administered formulation, route, background, and endpoint timing to distinguish the basis for judging directness.",
      "current_reports": [
        "S04"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "Saki 2025 is described in the original KO as a study adding intramuscular dexpanthenol to topical adapalene, while the original paper title says Pantothenic Acid. The single-blind design, 2 months, analysis groups of 31/28, and between-group P=0.476 for inflammatory-lesion endpoint values are preserved. This is a nonsignificant result for a different route/molecule and is not used as an oral B5 effect of 0 or repeated counterevidence.",
      "condition_status": "Partly verified",
      "status_reason": "The separate result and exclusion boundaries were linked, but the external formulation/molecule, denominators, and original table were not newly verified.",
      "missingness": "Actual formulation identity, group correspondence, endpoint variances/intervals, and detailed material on that background remain to be verified.",
      "uncertainty": "Nonsignificance is not an effect of 0 or equivalence, and the title and administered-molecule wording are not arbitrarily corrected.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Saki's actual molecule/formulation, intramuscular administration, adapalene background, analysis groups/time points, and original results table."
    },
    {
      "item_id": "N25",
      "question_type": "Historical hypotheses and bibliographic records",
      "question": "Was the Leung bibliographic lead kept from being converted into an eligible RCT result?",
      "needed": "Leung's original text, actual study design/population, single-ingredient oral intervention, and between-group inflammatory-lesion results.",
      "role": "Required (candidate boundaries)",
      "role_reason": "Needed to avoid creating a single-ingredient RCT or a causal effect merely because a citation exists.",
      "application_exception": "Do not interpret unacquired full text or an unverified design as a negative result or absence of research.",
      "criterion": "Distinguish indexing, hypotheses, and citations in other papers from actual controlled designs and verified results.",
      "basis": "The distinction between studies and reports in M04 §4.6.1–4.6.2; cohort/outcome linkage is an internal application; M04 §4.5, §4.6.3; limitations on the current material conversion reflect the user's scope and internal design; M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is internally designed — internal adaptation for historical hypotheses/bibliographic records. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "If the original text is acquired, separate hypotheses from observational/trial results and compare them with the current question using an eligibility table.",
      "current_reports": [
        "S05"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "Leung 1995 is classified in the original evidence as a historical hypothesis/related report; the directly relevant controlled design, n, and between-group inflammatory-lesion results in the original text are unverified. Historical access is recorded as metadata_search_index, and the publisher's full text is recorded as not having been obtained.",
      "condition_status": "Unverified",
      "status_reason": "A bibliographic identity is available, but no material links it to an eligible comparative result.",
      "missingness": "The original text, comparative design, actual intervention, and between-group inflammatory-lesion analysis are needed.",
      "uncertainty": "The historical failure to acquire material recorded in the manuscript does not mean a new access failure in this review.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Leung's original text, actual study design/population, single-ingredient oral intervention, and between-group inflammatory-lesion results."
    },
    {
      "item_id": "N26",
      "question_type": "Legacy and other endpoints",
      "question": "Were S09–S11 kept from being repurposed as direct acne results?",
      "needed": "The original citations' populations, routes, and endpoints, and the scope of legacy carryover; original results if needed.",
      "role": "Required (attribution of related material)",
      "role_reason": "Needed to avoid combining different populations, routes, and measures merely because they share a vitamin name or concern skin.",
      "application_exception": "The legacy 028 or reference files are not labeled as directly read in this review, and their clinical numerical values are not inherited.",
      "criterion": "Distinguish material carried over from legacy 028, female hair loss, and topical dexpanthenol/hydration/barrier outcomes from the current question.",
      "basis": "Question-clarification principles in M03 §3.1, §3.2.1–3.2.4; detailed separation rules are internally designed; the distinction between studies and reports in M04 §4.6.1–4.6.2; cohort/outcome linkage is an internal application; M03 §3.2.2–3.2.3; reverse-direction labeling and test adaptations are internally designed; M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are internally designed — internal adaptation for legacy/other endpoints. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Separate each carried-over citation into a population, molecule, route, and endpoint table to distinguish discovery context from direct results.",
      "current_reports": [
        "S09",
        "S10",
        "S11"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "S09 is a comparison involving calcium pantothenate and other treatments for female hair loss, S10 is a review of topical dexpanthenol, and S11 is a bibliographic record for a topical barrier/hydration study. The original citation specifies that only sources and boundaries were carried over from the previous 028 and that these are not numerical clinical evidence for this review. The current external originals and legacy 028 were not read.",
      "condition_status": "Met",
      "status_reason": "The current citations verified the scope of carryover and the boundary that these concern different questions. The efficacy of those studies was not newly verified.",
      "missingness": "Full original texts and comparison of these materials' specific populations/results are outside this review's scope and are not filled in as current numerical values.",
      "uncertainty": "Hair-loss and topical hydration/barrier results are not results for inflammatory lesions in acne treated with oral single-ingredient supplementation.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "The original citations' populations, routes, and endpoints, and the scope of legacy carryover; original results if needed."
    },
    {
      "item_id": "N27",
      "question_type": "Registration and analysis plans",
      "question": "Can the planned inflammatory endpoints/time points be compared with the reports?",
      "needed": "Official registration history, protocol, SAP, reasons for endpoint changes, and reported results.",
      "role": "Required",
      "role_reason": "Because material is needed to compare reporting of total lesions as primary and inflammatory lesions as secondary with advance plans and possible selective reporting.",
      "application_exception": "Do not convert an empty nct value or gaps in registration access into nonregistration, confirmed selective reporting, or negative results. The S02 slide is not a protocol.",
      "criterion": "Compare the target endpoints/time points/denominators in registrations, protocols, and SAP with actual reports, and explicitly state nonacquisition.",
      "basis": "M08 Table 8.2.a, M04 §4.6.3; internal application; M04 §4.5, §4.6.3; limitations on the current material conversion reflect the user's scope and internal design — internal adaptation for registration/analysis plans. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Compare initial registration/change histories, protocols, and SAP with report endpoints, time points, and analyses step by step.",
      "current_reports": [
        "S01",
        "S02",
        "S03",
        "S04"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original limitations explicitly state that registration/analysis plans are unverified, and the nct values in evidence are empty. The original search summary reports some registration/API access failures. S02 is a single summary slide, not a composition certificate or protocol. No registration/API lookup was performed in this review.",
      "condition_status": "Unverified",
      "status_reason": "No material permits direct comparison of advance plans with actual endpoints/denominators.",
      "missingness": "Official registration content/history, protocols, SAP, and reasons for changes are needed.",
      "uncertainty": "The detailed access-failure log was not read in this review, so no new failure event or nonregistration is established.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Official registration history, protocol, SAP, reasons for endpoint changes, and reported results."
    },
    {
      "item_id": "N28",
      "question_type": "Funding and conflicts of interest",
      "question": "Were sponsorship, institutions, declarations, and unverified information distinguished?",
      "needed": "Research funding/publication fees, product provision, author employment/patents, COI, and sponsor roles in the research.",
      "role": "Supplementary; required for claims of independence",
      "role_reason": "Needed to avoid automatically accepting a declaration of no conflicts of interest or unverified funding as independent replication or absence of bias.",
      "application_exception": "Do not exclude results merely because sponsorship exists, and do not sustain a claim of independence using unverified information.",
      "criterion": "Record each report's funding, publication fees, affiliations, and COI declarations separately from unverified employment/product provision/patents.",
      "basis": "Chamgap's own conditions for independence and attribution. The official methodology sections in this pilot do not endorse all of these detailed items — internal adaptation for funding/conflicts of interest. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Compare funding sources, institutions, employment, patents, and sponsor roles by report in a table, and preserve results regardless of their direction.",
      "current_reports": [
        "S01",
        "S03",
        "S04",
        "S05"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "S01 reports Avilan research funding, Nutraceutical Medical Research publication fees, and a declaration of no conflicts of interest. S03 is affiliated with Nutraceutical Medical Research, while details of funding, product provision, employment/patents, and COI are unverified. S04 is retained with Shiraz University, Actoverco, and a declaration of no conflicts of interest; S05 is retained with funding unverified.",
      "condition_status": "Partly verified",
      "status_reason": "The reported funding/declarations were verified, but not all employment, patents, or sponsor roles were verified.",
      "missingness": "Details for S03/S05 and each sponsor's roles in design, analysis, and publication remain unresolved.",
      "uncertainty": "Funding or COI declarations alone are not used to make a new judgment about independence or the reliability of the results.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Research funding/publication fees, product provision, author employment/patents, COI, and sponsor roles in the research."
    },
    {
      "item_id": "N29",
      "question_type": "Direct replication and differences",
      "question": "Were differences among related studies kept from being counted as independent replications of single-active-ingredient treatment?",
      "needed": "Unique trial identity, eligibility/results tables, single-active-ingredient composition, each endpoint/time point, and information on independent institutions.",
      "role": "Required (interpretation of replication)",
      "role_reason": "Needed to avoid turning results from the same brand, appendices, or other routes into reproduction or replicated refutation of efficacy for inflammatory lesions from a single active ingredient.",
      "application_exception": "Do not extend unverified direct eligibility to 0 studies worldwide or assign Not applicable to unverified study-family information.",
      "criterion": "Distinguish direct replications that match the report family, single-active-ingredient status, population, route, lesion type, and time point from adjacent results.",
      "basis": "Distinction between studies and reports in M04 §4.6.1–4.6.2; cohort/outcome linkage is an internal application; M04 §4.6.1–4.6.2, M15 §15.3.1; internal application — internal adaptation for direct replication and differences. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "First compare eligibility and outcome differences by trial, then review direct independent replication separately after deduplication.",
      "current_reports": [
        "S01",
        "S02",
        "S03",
        "S04",
        "S05"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original assessment limits its statement to not having verified a directly eligible controlled trial of a single active ingredient for the fixed endpoint, and records the existence of related human studies as true. Positive combination-product results, uncontrolled within-group results, nonsignificant results from another route, and hypothesis candidates were not added together as direct replications of single-active-ingredient treatment.",
      "condition_status": "Unverified",
      "status_reason": "Eligible single-active-ingredient results and independence information needed for a direct replication comparison are unavailable.",
      "missingness": "Effects, conditions, independence, and overlap linkages for each directly eligible study family are needed.",
      "uncertainty": "Empty replication/independence values do not prove 0 replications or agreement in the same direction.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Unique trial identity, eligibility/results tables, single-active-ingredient composition, each endpoint/time point, and information on independent institutions."
    },
    {
      "item_id": "N30",
      "question_type": "Clinical importance",
      "question": "Is there evidence for judging the clinical importance of a difference in lesion counts?",
      "needed": "Between-group effects/CI for the target inflammatory lesions, evidence of importance from the patient's perspective, and prespecified criteria.",
      "role": "Required (interpretation of importance)",
      "role_reason": "Needed to avoid declaring a clinically sufficient effect for the original question based only on significance for total lesions or study size.",
      "application_exception": "Do not assign numerical values to MCID, a minimum lesion difference, sample size, or duration without supporting evidence.",
      "criterion": "Link direct effects/intervals separately to criteria for a lesion difference that matters to patients.",
      "basis": "M15 §15.3.1–15.3.3; internal application — internal adaptation for clinical importance. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Review criteria linking patient experience to lesion differences, then present their relationship to the original intervals within a prespecified interpretation framework.",
      "current_reports": [
        "S01"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original assessment limitations leave MCID unverified, and direct effects/CI are also empty. Total-lesion P=0.0197 and 68.21% were not used as criteria for the clinical sufficiency of single-active-ingredient inflammatory-lesion results.",
      "condition_status": "Unverified",
      "status_reason": "Both the direct effect and the important-difference criterion are unverified, so sufficiency cannot be interpreted.",
      "missingness": "A direct interval for inflammatory lesions and an evidence-based criterion for an important difference are needed.",
      "uncertainty": "Do not turn the current judgment ? into a new conclusion of a clinically small effect or no effect.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Between-group effects/CI for the target inflammatory lesions, evidence of importance from the patient's perspective, and prespecified criteria."
    },
    {
      "item_id": "N31",
      "question_type": "Mechanistic and clinical boundaries",
      "question": "Were NAD/skin-hydration results kept from being used as effects on inflammatory lesions?",
      "needed": "Definition of the selected endpoint and the actual evidence and interpretive scope for each related mechanism/other clinical measure.",
      "role": "Supplementary; required for expansion to other clinical questions",
      "role_reason": "Needed to prevent mechanistic plausibility or skin relevance from substituting for the original question of oral single-active-ingredient efficacy.",
      "application_exception": "Because the lesions themselves are the treatment target, do not impose clinical-event/mortality trials as mandatory for this lesion-count question.",
      "criterion": "Distinguish the lesion count being treated from mechanisms, nutritional markers, topical barrier/hydration, and separate quality-of-life/event questions.",
      "basis": "M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptation is internally designed; M03 §3.2.4; internally defined extension boundaries — internal adaptation for mechanistic and clinical boundaries. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Record mechanistic explanations and clinical lesion comparisons as separate lines of evidence, and handle new questions such as quality of life or scarring through a separate boundary review.",
      "current_reports": [
        "S01",
        "S10",
        "S11"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original classification is a P endpoint in which inflammatory lesions themselves are the treatment target. The presence of pantothenic acid, NAD/cellular mechanisms, or topical moisturization does not demonstrate reduction of inflammatory lesions with an oral single active ingredient, and is not extended to effects on quality of life, scarring, or other events.",
      "condition_status": "Met",
      "status_reason": "The original P classification was linked to the boundary against substitution by related measures. No new efficacy judgment for events was created.",
      "missingness": "The complete original texts on mechanisms/topical outcomes were not read in this review, and the direct effect for the selected question remains unverified.",
      "uncertainty": "A P classification does not mean efficacy is verified, and it is not changed to S on the basis that lesions are counted by an observer.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Definition of the selected endpoint and the actual evidence and interpretive scope for each related mechanism/other clinical measure."
    },
    {
      "item_id": "N32",
      "question_type": "Obligations for expanded questions",
      "question": "Are optimal dose, persistence after discontinuation, and subgroup effects imposed as mandatory?",
      "needed": "Direct dose comparisons, discontinuation/long-term follow-up, and prespecified subgroup and interaction data when making expanded claims.",
      "role": "Supplementary; required only for the relevant expansion",
      "role_reason": "Needed to avoid making every dose, long-term, and subgroup study outside the assessed question universally mandatory.",
      "application_exception": "Unverified actual doses and assessment time points for the single-active-ingredient product remain under the separate required conditions N10/N11 and are not erased by this Not applicable status.",
      "criterion": "Treat claims about optimization, persistence, and subgroups that are absent from the current narrow lesion-count question as separate questions.",
      "basis": "M03 §3.2.1–3.2.4; details on dose, persistence, and effect modification are internally designed — internal adaptation for obligations for expanded questions. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "If an expanded question is raised, separately design direct dose comparisons, follow-up after discontinuation, or a prespecified effect-modification plan.",
      "current_reports": [
        "S01",
        "S03"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original /ko/effect is the single question of reducing inflammatory lesion counts in adults with mild-to-moderate facial acne; it makes no claim about optimal dose, persistence after discontinuation, or efficacy in specific subgroups. Only a blanket obligation to conduct these expanded studies is not applicable.",
      "condition_status": "Not applicable",
      "status_reason": "The obligation for expansion outside the narrow assessed question was treated as not applicable. Unverified actual single-active-ingredient dose, duration, and population remain unchanged.",
      "missingness": "Expanded outcomes were not verified; a new expanded question would require separate evidence.",
      "uncertainty": "Do not substitute Not applicable for unread material or unverified efficacy.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Direct dose comparisons, discontinuation/long-term follow-up, and prespecified subgroup and interaction data when making expanded claims."
    },
    {
      "item_id": "N33",
      "question_type": "Adverse-event records",
      "question": "Was the lack of reported serious adverse events in a short combination-product study kept from being turned into safety?",
      "needed": "Tables of adverse events by arm, event/person counts, collection methods, denominators/durations, and discontinuation/missing data for a single-active-ingredient product.",
      "role": "Supplementary; required for safety interpretation",
      "role_reason": "Needed to avoid generalizing nonreporting in a small combination-product study into 0 events during long-term single-active-ingredient use or safety certification.",
      "application_exception": "Do not calculate unreported event counts, incidence, or discontinuations, or generate causal harm estimates.",
      "criterion": "Distinguish harm collection, events/persons, exposure/denominators, discontinuation, and nonreporting by product/duration.",
      "basis": "M19 §19.1.2–19.2.4; internal application; M19 §19.1.2–19.2.4; detailed distinctions are internally designed; M19 §19.1.2–19.2.4, M04 §4.6.3; internal application — internal adaptation for adverse-event records. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Plan systematic harm collection and follow-up of discontinuations in the same formulation, population, and duration, and report persons/events and denominators separately.",
      "current_reports": [
        "S01",
        "S03",
        "S06"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original caution wording states that the lack of reported serious adverse events in the small 12-week combination-product trial was not generalized to long-term safety of a single-active-ingredient product. The current archived summaries contain no table of adverse events by arm, collection methods, denominators, or discontinuations for a directly relevant single-active-ingredient product.",
      "condition_status": "Unverified",
      "status_reason": "The safety boundary is preserved, but quantitative harm and completeness-of-collection data for a directly relevant single-active-ingredient product are unverified.",
      "missingness": "Arm-specific counts of people with harm/events, exposure duration, collection methods, discontinuation, and the scope of nonreporting are needed.",
      "uncertainty": "Nonreporting differs from 0 events, safety, or absence of a cause. The 41 evaluable people for the product as a whole are not transferred to the harm-analysis denominator.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Tables of adverse events by arm, event/person counts, collection methods, denominators/durations, and discontinuation/missing data for a single-active-ingredient product."
    },
    {
      "item_id": "N34",
      "question_type": "Nutrition and risk examples",
      "question": "Were the meanings of 5 mg/day, 10 g/day, and the absence of an established UL distinguished?",
      "needed": "Relevant sections of official nutrition/excess-intake risk documents and safety data for the actual formulation, population, and exposure.",
      "role": "Supplementary; required for defining safety scope",
      "role_reason": "Needed to avoid mistaking official examples and an unestablished upper limit for an individual therapeutic dose or unlimited safety.",
      "application_exception": "The official web document was not newly read in this review, and the original numbers are not converted into toxicity thresholds or efficacious doses.",
      "criterion": "Distinguish nutritional reference values, gastrointestinal harm examples, and the absence of an established upper intake level from therapeutic doses, toxicity thresholds, or safety guarantees.",
      "basis": "M19 §19.1.2–19.2.4; internal application; Chamgap's own interpretation boundaries. M19 principles are referenced; no formal causality tool was applied; M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptation is internally designed — internal adaptation for nutrition and risk examples. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Compare the nature of official reference values and examples of harm-associated exposure by formulation, population, and duration, keeping them separate from personal recommendations.",
      "current_reports": [
        "S06"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The preserved safety wording describes the adult adequate intake of 5 mg/day as a nutritional reference value and NIH's 10 g/day as an example associated with diarrhea/gastrointestinal discomfort. The 10 g/day value is not a toxicity threshold or intake recommendation, and the absence of an established UL does not mean unlimited safety.",
      "condition_status": "Met",
      "status_reason": "The original numbers and interpretive limitations were carried over. This is not new safety certification or personal dosing instructions.",
      "missingness": "Safety estimates and quantitative harm data for directly relevant single-active-ingredient high-dose use for acne remain separately unverified.",
      "uncertainty": "The presence of an official web URL or the original access_level does not mean that updates to the material were verified in this review.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Relevant sections of official nutrition/excess-intake risk documents and safety data for the actual formulation, population, and exposure."
    },
    {
      "item_id": "N35",
      "question_type": "Long-term use and vulnerable groups",
      "question": "Were safety gaps for high doses, special populations, and interactions retained?",
      "needed": "Data on long-term use/special populations, underlying diseases, concomitant medications, interactions, and discontinuation/recovery for single-active-ingredient formulations.",
      "role": "Supplementary; required for the relevant safety expansion",
      "role_reason": "Needed to avoid generalizing limited product observations or a statement of no known interactions into safety for all populations.",
      "application_exception": "Do not impose every rare-harm study on the narrow lesion-efficacy question, and do not newly assess individual causality, risk, or discontinuation/rechallenge.",
      "criterion": "Distinguish short-term product observations from the scope of long-term single-active-ingredient use, pregnancy/lactation, children, liver/kidney disease, and concomitant medications.",
      "basis": "M19 §19.1.2–19.2.4; internal application; design considerations in M19 §19.2.2–19.2.4; detailed recording of confounding is internally designed — internal adaptation for long-term use and vulnerable groups. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Review designs for harm follow-up that distinguish populations, durations, and concomitant exposures, and report information gaps for vulnerable groups separately.",
      "current_reports": [
        "S01",
        "S06"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The manuscript explicitly states that the safety of high-dose use for acne in pregnancy, lactation, children, and liver/kidney disease is unverified. The statement that no important drug interactions are known does not exclude all interactions. Short combination-product data were not extended to long-term single-active-ingredient use.",
      "condition_status": "Unverified",
      "status_reason": "The original gaps are retained because direct verification of expanded safety data is absent.",
      "missingness": "Direct data by duration, underlying disease, vulnerable group, and concomitant medication remain needed.",
      "uncertainty": "Lack of interaction information does not mean 0 interactions or individual safety.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Data on long-term use/special populations, underlying diseases, concomitant medications, interactions, and discontinuation/recovery for single-active-ingredient formulations."
    },
    {
      "item_id": "N36",
      "question_type": "Search and update scope",
      "question": "Was the lack of direct verification kept from being extended to worldwide absence or a current search?",
      "needed": "Original search/selection ledger, registration/access records, correction/retraction information, and current original-text versions.",
      "role": "Required",
      "role_reason": "Needed to avoid guaranteeing an absence of studies in a current exhaustive search from a direct evidence gap within the recorded search scope.",
      "application_exception": "No searches, external full-text reading, or registration/API lookups were performed in this review. Failures described in the manuscript are not retroactively relabeled as events in this review.",
      "criterion": "Specify the original reference date, search/access limitations at that time, the scope of the current preservation conversion, and links to individual updates.",
      "basis": "M04 §4.5, §4.6.3; limitations on the current material conversion reflect the user's scope and internal design; M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is internally designed — internal adaptation for search and update scope. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "If new material becomes available within an authorized scope, distinguish search/access events, additions of evidence, and revisions of conditions, and re-review the linked rows.",
      "current_reports": [
        "S01",
        "S02",
        "S03",
        "S04",
        "S05",
        "S06"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original reference date is 2026-09-15, and the judgment is limited to targeted search-engine searches, citation tracking, and accessible original texts. Some PubMed and registration/API failures and unacquired full texts are disclosed. The conversion in this review on 2026-10-05 involves reading archived materials, with no new search. New single-active-ingredient trials, composition information, target outcomes/SAP, corrections, or safety information are reasons for updates under the same ID/URL.",
      "condition_status": "Met",
      "status_reason": "The scope verified at that time was distinguished from and linked to the current work and specific reasons for updates.",
      "missingness": "Worldwide completeness, absence of unpublished studies, and the latest retraction/correction status were not verified in this review.",
      "uncertainty": "This is a gap within the accessible scope; it does not declare 0 eligible studies worldwide.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "Original search/selection ledger, registration/access records, correction/retraction information, and current original-text versions."
    },
    {
      "item_id": "N37",
      "question_type": "Preservation of the original judgment",
      "question": "Were the scope of the original ?, empty values, axes, and direct-human-evidence flags preserved?",
      "needed": "The gate scope of the original grade/score, axes, and assessment_profile, together with self-review and publication metadata.",
      "role": "Required (preservation contract)",
      "role_reason": "Needed to avoid turning unverified direct eligibility into absence of all human evidence, a score of 0, no effect, or new clinical certification.",
      "application_exception": "Do not inherit C from an adjacent product or C from legacy 028, and do not use the original self-review or grade_revalidated as independent certification in this review.",
      "criterion": "Preserve the original ?/empty score, B/P, unscored empty values, and flags restricted to direct eligibility without a new judgment.",
      "basis": "Question-clarification principles in M03 §3.1, §3.2.1–3.2.4; detailed separation rules are internally designed; M04 §4.5, §4.6.3; limitations on the current material conversion reflect the user's scope and internal design — internal adaptation for preservation of the original judgment. This is not official methodological certification.",
      "condition_origin": "Case-specific development conditions designed with knowledge of the current original content. This is not blinded validation or preregistration.",
      "proposed_research": "Compare the preserved original text and display values, and treat only data/table-conversion errors as separate correction events.",
      "current_reports": [
        "S01",
        "S03",
        "S04",
        "S05"
      ],
      "existence": "Linkage to the exact locations, values, and identities in the currently preserved archived summaries; separate from acquisition of external documents.",
      "acquired_read": "Summary reading: the currently archived summaries were actually read; external original texts, registrations, and old separate files were not read.",
      "observation": "The original grade is ?, score is empty, and the 7 axes are B/P/the remaining five empty values. no_human_study=true and human_study_exists=false refer to directly eligible controlled trials of a single active ingredient for the fixed endpoint, while the existence of related human studies is true. The numerical and denominator fields of primary_effect are empty, and the original safety is Caution. Historical first_published_at and ready metadata do not mean publication on the website was completed in this review.",
      "condition_status": "Met",
      "status_reason": "The original values and scope were linked unchanged, without creating new scores, grades, effects, or publication certification.",
      "missingness": "Unscored axes, direct between-group results, and full-text/registration gaps remain unchanged.",
      "uncertainty": "The original single-assistant self-review and document quality B are neither independent clinical review nor a new efficacy grade B.",
      "review_date": "2026-10-05",
      "reading_status": "Original text not read · Archived summary read",
      "additional_material": "The gate scope of the original grade/score, axes, and assessment_profile, together with self-review and publication metadata."
    }
  ],
  "reports": [
    {
      "report_id": "S01",
      "title": "Yang et al. 2014. A Randomized, Double-Blind, Placebo-Controlled Study of a Novel Pantothenic Acid-Based Dietary Supplement in Subjects with Mild to Moderate Facial Acne",
      "url": "https://link.springer.com/article/10.1007/s13555-014-0052-3",
      "report_type": "related_controlled_product",
      "existence": "This refers to archived bibliographic information and past records; current external responses have not been verified.",
      "acquired_read": "The relevant Korean/English summaries and bibliographic records in the archived manuscript were read. The linked external original materials were not read in this review.",
      "study_family": "F01",
      "independent_replication": false,
      "observed_result": "48 people allocated, 41 evaluable, with reported group counts of 20/21. The total-lesion P=0.0197 and the expression 68.21%, along with baseline inflammatory-lesion means (SD) of 15.3(8.9)/17.3(14.3), are preserved. Complete composition, single-active-ingredient status, and the target between-group inflammatory-lesion effect are unverified.",
      "result_level": "This is content recorded in the archived manuscript. It is not the result of a new comparison with current external original materials.",
      "source_evidence_date": "2026-09-15",
      "materials": [
        {
          "material_type": "Publisher's article web full text",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "12-week total-lesion/inflammatory-lesion report on a related product whose single-active-ingredient status is unverified; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: full_text. Historical location in the reference bibliography: Methods; Results; Table 1 and Figures 1–3, printed pp. 95–97; Acknowledgments, p. 100 Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S01-M1",
          "url": "https://link.springer.com/article/10.1007/s13555-014-0052-3",
          "parent_url": null
        },
        {
          "material_type": "DOI identifier and publisher-link entry point",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "12-week total-lesion/inflammatory-lesion report on a related product whose single-active-ingredient status is unverified; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: Unverified. Historical location in the reference bibliography: Methods; Results; Table 1 and Figures 1–3, printed pp. 95–97; Acknowledgments, p. 100 The original citation's historical access is a record in the context of the article report. The historical access/reading level of this DOI identifier-link entry point itself was not separately verified. Currently, access has not been attempted and it has not been read. Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S01-M2",
          "url": "https://doi.org/10.1007/s13555-014-0052-3",
          "parent_url": null
        }
      ],
      "links": [
        {
          "label": "Source",
          "url": "https://link.springer.com/article/10.1007/s13555-014-0052-3"
        }
      ]
    },
    {
      "report_id": "S02",
      "title": "Yang 2014 electronic supplementary material — summary slide",
      "url": "https://media.springernature.com/original/springer-static/esm/art%3A10.1007%2Fs13555-014-0052-3/MediaObjects/13555_2014_52_MOESM1_ESM.pdf",
      "report_type": "same_study_supplement",
      "existence": "This refers to archived bibliographic information and past records; current external responses have not been verified.",
      "acquired_read": "The relevant Korean/English summaries and bibliographic records in the archived manuscript were read. The linked external original materials were not read in this review.",
      "study_family": "F01",
      "independent_replication": false,
      "observed_result": "The original location explicitly describes a single-page summary slide, not a composition certificate or protocol. It is grouped in the same report family as S01 and is not counted as a separate trial or participants.",
      "result_level": "This is content recorded in the archived manuscript. It is not the result of a new comparison with current external original materials.",
      "source_evidence_date": "2026-09-15",
      "materials": [
        {
          "material_type": "Article supplementary summary-slide PDF",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Supplementary summary of the same paper as S01; not an independent replication; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: full-text PDF document. Historical location in the reference bibliography: One-page summary slide, not a formulation certificate or protocol Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S02-M1",
          "url": "https://media.springernature.com/original/springer-static/esm/art%3A10.1007%2Fs13555-014-0052-3/MediaObjects/13555_2014_52_MOESM1_ESM.pdf",
          "parent_url": null
        }
      ],
      "links": [
        {
          "label": "Source",
          "url": "https://media.springernature.com/original/springer-static/esm/art%3A10.1007%2Fs13555-014-0052-3/MediaObjects/13555_2014_52_MOESM1_ESM.pdf"
        }
      ]
    },
    {
      "report_id": "S03",
      "title": "Capodice JL. 2012. Feasibility, Tolerability, Safety and Efficacy of a Pantothenic Acid Based Dietary Supplement in Subjects with Mild to Moderate Facial Acne Blemishes",
      "url": "https://www.researchgate.net/publication/264852547_Feasibility_Tolerability_Safety_and_Efficacy_of_a_Pantothenic_Acid_Based_Dietary_Supplement_in_Subjects_with_Mild_to_Moderate_Facial_Acne_Blemishes",
      "report_type": "related_uncontrolled_product",
      "existence": "This refers to archived bibliographic information and past records; current external responses have not been verified.",
      "acquired_read": "The relevant Korean/English summaries and bibliographic records in the archived manuscript were read. The linked external original materials were not read in this review.",
      "study_family": "F02",
      "independent_replication": false,
      "observed_result": "Uncontrolled, open-label, 8 weeks, with 11 enrolled and 10 completing. The product contains other vitamins and L-carnitine, with 2 tablets taken 2 times daily. The total-lesion change of 20.45→11.18 is a within-group result, not an inflammatory-lesion effect versus placebo. Identity with the 2014 batch is unverified.",
      "result_level": "This is content recorded in the archived manuscript. It is not the result of a new comparison with current external original materials.",
      "source_evidence_date": "2026-09-15",
      "materials": [
        {
          "material_type": "Article-sharing and full-text mirror page",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Multicomponent product and within-group change in total lesions; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: full_text_mirror. Historical location in the reference bibliography: Journal of Cosmetics, Dermatological Sciences and Applications 2(3):132–135; section 2.2 (p.133), section 3/Table 1 (p.134) Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S03-M1",
          "url": "https://www.researchgate.net/publication/264852547_Feasibility_Tolerability_Safety_and_Efficacy_of_a_Pantothenic_Acid_Based_Dietary_Supplement_in_Subjects_with_Mild_to_Moderate_Facial_Acne_Blemishes",
          "parent_url": null
        },
        {
          "material_type": "DOI identifier and publisher-link entry point",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Multicomponent product and within-group change in total lesions; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: Unverified. Historical location in the reference bibliography: Journal of Cosmetics, Dermatological Sciences and Applications 2(3):132–135; section 2.2 (p.133), section 3/Table 1 (p.134) The original citation's historical access is a record in the context of the article report. The historical access/reading level of this DOI identifier-link entry point itself was not separately verified. Currently, access has not been attempted and it has not been read. Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S03-M2",
          "url": "https://doi.org/10.4236/jcdsa.2012.23026",
          "parent_url": null
        }
      ],
      "links": [
        {
          "label": "Source",
          "url": "https://www.researchgate.net/publication/264852547_Feasibility_Tolerability_Safety_and_Efficacy_of_a_Pantothenic_Acid_Based_Dietary_Supplement_in_Subjects_with_Mild_to_Moderate_Facial_Acne_Blemishes"
        }
      ]
    },
    {
      "report_id": "S04",
      "title": "Saki et al. 2025. Efficacy of Intramuscular Pantothenic Acid in the Treatment of Acne Vulgaris: A Single Blind Randomized Clinical Trial",
      "url": "https://onlinelibrary.wiley.com/doi/10.1155/dth/6610699",
      "report_type": "different_route_molecule",
      "existence": "This refers to archived bibliographic information and past records; current external responses have not been verified.",
      "acquired_read": "The relevant Korean/English summaries and bibliographic records in the archived manuscript were read. The linked external original materials were not read in this review.",
      "study_family": "F03",
      "independent_replication": false,
      "observed_result": "The original KO describes intramuscular dexpanthenol added to topical adapalene, while the citation title says Pantothenic Acid. Single-blind, 2 months, analysis groups 31/28, between-group endpoint-value P=0.476. This is not used as evidence of an oral B5 effect of 0 or as replicated refutation.",
      "result_level": "This is content recorded in the archived manuscript. It is not the result of a new comparison with current external original materials.",
      "source_evidence_date": "2026-09-15",
      "materials": [
        {
          "material_type": "Publisher's article web full text",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Comparison of inflammatory-lesion endpoint values using a different route, molecule, and background; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: full_text. Historical location in the reference bibliography: Methods 2.1–2.4; Table 5; Funding and Conflicts of Interest Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S04-M1",
          "url": "https://onlinelibrary.wiley.com/doi/10.1155/dth/6610699",
          "parent_url": null
        },
        {
          "material_type": "DOI identifier and publisher-link entry point",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Comparison of inflammatory-lesion endpoint values using a different route, molecule, and background; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: Unverified. Historical location in the reference bibliography: Methods 2.1–2.4; Table 5; Funding and Conflicts of Interest The original citation's historical access is a record in the context of the article report. The historical access/reading level of this DOI identifier-link entry point itself was not separately verified. Currently, access has not been attempted and it has not been read. Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S04-M2",
          "url": "https://doi.org/10.1155/dth/6610699",
          "parent_url": null
        }
      ],
      "links": [
        {
          "label": "Source",
          "url": "https://onlinelibrary.wiley.com/doi/10.1155/dth/6610699"
        }
      ]
    },
    {
      "report_id": "S05",
      "title": "Leung LH. 1995. Pantothenic acid deficiency as the pathogenesis of acne vulgaris",
      "url": "https://pubmed.ncbi.nlm.nih.gov/7476595/",
      "report_type": "hypothesis_discovery_unverified",
      "existence": "This refers to archived bibliographic information and past records; current external responses have not been verified.",
      "acquired_read": "The relevant Korean/English summaries and bibliographic records in the archived manuscript were read. The linked external original materials were not read in this review.",
      "study_family": "F04",
      "independent_replication": false,
      "observed_result": "The comparison design, n, and between-group inflammatory-lesion results for a single active ingredient in the original text are unverified. Historical metadata_search_index and the unacquired publisher full text are preserved, without turning the citation into eligible RCT results.",
      "result_level": "This is content recorded in the archived manuscript. It is not the result of a new comparison with current external original materials.",
      "source_evidence_date": "2026-09-15",
      "materials": [
        {
          "material_type": "PubMed bibliographic and indexing page",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Historical hypothesis/bibliographic lead; direct comparison unverified; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: metadata_search_index. Historical location in the reference bibliography: PubMed indexed title/DOI; full publisher article not obtained Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S05-M1",
          "url": "https://pubmed.ncbi.nlm.nih.gov/7476595/",
          "parent_url": null
        },
        {
          "material_type": "DOI identifier and publisher-link entry point",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Historical hypothesis/bibliographic lead; direct comparison unverified; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: Unverified. Historical location in the reference bibliography: PubMed indexed title/DOI; full publisher article not obtained The original citation's historical access is a record in the context of the article report. The historical access/reading level of this DOI identifier-link entry point itself was not separately verified. Currently, access has not been attempted and it has not been read. Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S05-M2",
          "url": "https://doi.org/10.1016/0306-9877(95)90512-X",
          "parent_url": null
        }
      ],
      "links": [
        {
          "label": "Source",
          "url": "https://pubmed.ncbi.nlm.nih.gov/7476595/"
        }
      ]
    },
    {
      "report_id": "S06",
      "title": "NIH Office of Dietary Supplements. Pantothenic Acid — Health Professional Fact Sheet",
      "url": "https://ods.od.nih.gov/factsheets/PantothenicAcid-HealthProfessional/",
      "report_type": "official_nutrition_safety",
      "existence": "This refers to archived bibliographic information and past records; current external responses have not been verified.",
      "acquired_read": "The relevant Korean/English summaries and bibliographic records in the archived manuscript were read. The linked external original materials were not read in this review.",
      "study_family": null,
      "independent_replication": false,
      "observed_result": "The adequate intake of 5 mg/day, the gastrointestinal harm example of 10 g/day, the absence of an established UL, and the interaction scope in the original safety summary are preserved. This is not material newly verifying acne efficacy, therapeutic doses, toxicity thresholds, or unlimited safety.",
      "result_level": "This is content recorded in the archived manuscript. It is not the result of a new comparison with current external original materials.",
      "source_evidence_date": "2026-09-15",
      "materials": [
        {
          "material_type": "NIH ODS official web document",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Explanation of nutrition, formulations, excess-intake risks, and interactions; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: full_text. Historical location in the reference bibliography: Table 1; Dietary supplements; Health Risks from Excessive Pantothenic Acid; Interactions with Medications Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S06-M1",
          "url": "https://ods.od.nih.gov/factsheets/PantothenicAcid-HealthProfessional/",
          "parent_url": null
        }
      ],
      "links": [
        {
          "label": "Source",
          "url": "https://ods.od.nih.gov/factsheets/PantothenicAcid-HealthProfessional/"
        }
      ]
    },
    {
      "report_id": "S09",
      "title": "Siavash M, Tavakoli F, Mokhtari F. 2017. Comparing the Effects of Zinc Sulfate, Calcium Pantothenate, Their Combination and Minoxidil Solution Regimens on Controlling Hair Loss in Women: A Randomized Controlled Trial. Journal of Research in Pharmacy Practice; PMID 28616431 / DOI 10.4103/jrpp.JRPP_17_17.",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5463555/",
      "report_type": "other_population_endpoint_inherited",
      "existence": "This refers to archived bibliographic information and past records; current external responses have not been verified.",
      "acquired_read": "The relevant Korean/English summaries and bibliographic records in the archived manuscript were read. The linked external original materials were not read in this review.",
      "study_family": null,
      "independent_replication": false,
      "observed_result": "This is bibliographic information on a comparison involving zinc/calcium pantothenate, a combination product, and minoxidil for female hair loss. The current citation explicitly inherits only the source/boundaries from legacy 028 and is not evidence for clinical numbers in this review.",
      "result_level": "This is content recorded in the archived manuscript. It is not the result of a new comparison with current external original materials.",
      "source_evidence_date": "2026-09-15",
      "materials": [
        {
          "material_type": "PMC article web full text",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Only the source/boundaries from legacy 028 are inherited; these are not acne numbers; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: inherited_local_record. Historical location in the reference bibliography: reference/legacy_028.json /citations/1 Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S09-M1",
          "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5463555/",
          "parent_url": null
        }
      ],
      "links": [
        {
          "label": "Source",
          "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5463555/"
        }
      ]
    },
    {
      "report_id": "S10",
      "title": "Ebner F, Heller A, Rippke F, Tausch I. 2002. Topical use of dexpanthenol in skin disorders. American Journal of Clinical Dermatology; PMID 12113650 / DOI 10.2165/00128071-200203060-00005.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/12113650/",
      "report_type": "topical_review_inherited",
      "existence": "This refers to archived bibliographic information and past records; current external responses have not been verified.",
      "acquired_read": "The relevant Korean/English summaries and bibliographic records in the archived manuscript were read. The linked external original materials were not read in this review.",
      "study_family": null,
      "independent_replication": false,
      "observed_result": "This is bibliographic information for a review of topical dexpanthenol in skin diseases. Only the source/boundaries were inherited from legacy 028, and it is not used as an inflammatory-lesion outcome for an oral single active ingredient.",
      "result_level": "This is content recorded in the archived manuscript. It is not the result of a new comparison with current external original materials.",
      "source_evidence_date": "2026-09-15",
      "materials": [
        {
          "material_type": "PubMed bibliographic and indexing page",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Legacy bibliographic boundaries for a review of topical use and a different molecule; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: inherited_local_record. Historical location in the reference bibliography: reference/legacy_028.json /citations/3 Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S10-M1",
          "url": "https://pubmed.ncbi.nlm.nih.gov/12113650/",
          "parent_url": null
        }
      ],
      "links": [
        {
          "label": "Source",
          "url": "https://pubmed.ncbi.nlm.nih.gov/12113650/"
        }
      ]
    },
    {
      "report_id": "S11",
      "title": "Gehring W, Gloor M. 2000. Effect of topically applied dexpanthenol on epidermal barrier function and stratum corneum hydration. Results of a human in vivo study. Arzneimittelforschung (Drug Research); PMID 10965426 / DOI 10.1055/s-0031-1300268.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/10965426/",
      "report_type": "topical_hydration_inherited",
      "existence": "This refers to archived bibliographic information and past records; current external responses have not been verified.",
      "acquired_read": "The relevant Korean/English summaries and bibliographic records in the archived manuscript were read. The linked external original materials were not read in this review.",
      "study_family": null,
      "independent_replication": false,
      "observed_result": "This is bibliographic information for research on barrier function and stratum-corneum hydration with topical dexpanthenol. Only the source/boundaries were inherited from legacy 028, and it is not a direct inflammatory-lesion result for oral acne treatment.",
      "result_level": "This is content recorded in the archived manuscript. It is not the result of a new comparison with current external original materials.",
      "source_evidence_date": "2026-09-15",
      "materials": [
        {
          "material_type": "PubMed bibliographic and indexing page",
          "public_status": "Unverified (no lookup in this review)",
          "access_status": "Not attempted in this review",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-11-02",
          "qualification": "Legacy bibliographic boundaries for topical barrier/hydration endpoints; The physical material type, historical access, and current reading level are distinguished. The original citation's bibliographic/URL identity is preserved; current external content/bytes are unverified. The original URL was preserved unchanged. No link access or verification of the identifier/physical document was performed in this review. A DOI entry point does not mean that the full text was acquired. Historical access dates for each material are unverified. The archived manuscript review date 2026-09-15 is not the access date of this original material file. Historical access level of this material itself: inherited_local_record. Historical location in the reference bibliography: reference/legacy_028.json /citations/4 Bibliographic access records are not inherited as access to a separate full text or underlying material. This does not mean that external original materials were acquired or full texts read in this review.",
          "material_id": "S11-M1",
          "url": "https://pubmed.ncbi.nlm.nih.gov/10965426/",
          "parent_url": null
        }
      ],
      "links": [
        {
          "label": "Source",
          "url": "https://pubmed.ncbi.nlm.nih.gov/10965426/"
        }
      ]
    }
  ],
  "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 document the question, eligibility criteria, and reasons for changes, and distinguish intervention variants.",
      "review_level": "Reuse of previously preserved HTML and principles from 1585. This is not new reading of full methodology, application of an official tool, or certification in this review."
    },
    {
      "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": "Distinguish and link studies and reports, and do not exclude a study solely because outcomes are unreported.",
      "review_level": "Reuse of previously preserved HTML and principles from 1585. This is not new reading of full methodology, application of an official tool, or certification in this review."
    },
    {
      "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 outcome and effect of interest, and review randomization, deviations, missing data, measurement, and selective reporting.",
      "review_level": "Reuse of previously preserved HTML and principles from 1585. This is not new reading of full methodology, application of an official tool, or certification in this review."
    },
    {
      "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": "Reuse of previously preserved HTML and principles from 1585. This is not new reading of full methodology, application of an official tool, or certification in this review."
    },
    {
      "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 designs, populations, and follow-up different from those for efficacy. Case reports do not establish incidence.",
      "review_level": "Reuse of previously preserved HTML and principles from 1585. This is not new reading of full methodology, application of an official tool, or certification in this review."
    }
  ],
  "status_dictionary": {
    "Met": "The original identity, values, and interpretive boundaries were verified in archived materials. This is separate from clinical sufficiency or certification.",
    "Partly verified": "Some material has been linked, but directness, detailed data, and comparison remain unresolved.",
    "Unverified": "The direct material/values needed within the preserved scope actually read are unverified. This does not mean no effect, 0 events, or incomplete review of the production work.",
    "Not applicable": "The obligation for expansion outside the narrow assessed question is not applicable. This is not a substitute for unread material.",
    "Not applicable (alias)": "Display alias for Not applicable.",
    "Not read": "External original materials were not directly read in this review; this is separate from the current reading of summaries.",
    "Conflicting information": "Original disagreement within the same item; no arbitrary correction.",
    "Review incomplete": "Individual review of table production remains incomplete. This is distinguished from insufficient evidence."
  },
  "study_overlap": {
    "state": "The current original evidence family labels and the same-paper linkage of S01/S02 are preserved. Independent trials, direct replications, and a summed participant total are not newly established. F01 (S01, S02): Yang 2014 main text and supplementary slide from the same study. Single-active-ingredient status and direct inflammatory-lesion results are unverified. / F02 (S03): 2012 multicomponent, uncontrolled, total-lesion within-group results; identity with the 2014 batch is unverified / F03 (S04): 2025 comparison of inflammatory-lesion endpoint values with intramuscular administration and a different molecule/background / F04 (S05): 1995 hypothesis/bibliographic candidate; original comparative design/single-active-ingredient results are unverified. The S01 main text and S02 supplementary summary concern the same study; report counts are not summed as independent trial counts or total participant counts.",
    "unique_trial_count": null,
    "unique_participant_count": null,
    "reason": "The current original evidence family labels and the same-paper linkage of S01/S02 are preserved. Independent trials, direct replications, and a summed participant total are not newly established. F01 (S01, S02): Yang 2014 main text and supplementary slide from the same study. Single-active-ingredient status and direct inflammatory-lesion results are unverified. / F02 (S03): 2012 multicomponent, uncontrolled, total-lesion within-group results; identity with the 2014 batch is unverified / F03 (S04): 2025 comparison of inflammatory-lesion endpoint values with intramuscular administration and a different molecule/background / F04 (S05): 1995 hypothesis/bibliographic candidate; original comparative design/single-active-ingredient results are unverified. The S01 main text and S02 supplementary summary concern the same study; report counts are not summed as independent trial counts or total participant counts."
  },
  "history": [
    {
      "date": "2026-11-02",
      "kind": "Public display and data separation",
      "view_version": "1.0",
      "change": "The public display and data were prepared from the existing 37 items. No new clinical search, verification-status change, or scoring was performed."
    }
  ],
  "language": "en",
  "translation_date": "2026-11-02"
}
