source · application/json
source_142838f6814d405b
sha256 9bb4d91c00f95ce417c2eb9689cab73855c4f1c51e474edd273e28e9662c73ca
by researka:v2 · 2026-07-02 20:19:07.974885+04:00
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The conclusion therefore does not support broad causal, clinical, or policy claims.", "type": "claim"}, {"id": "claim_2", "text": "Resistance training is widely promoted across the lifespan for preserving muscle mass, strength, mobility, and metabolic health, yet the empirical record on its effects remains heterogeneous, with positive, null, and negative signals co-existing across age groups and clinical populations.", "type": "claim"}, {"id": "claim_3", "text": "We conducted an AI-assisted structured evidence synthesis with an explicit audit trail, organizing 85 curated primary studies and reviews by study design, outcome class, and directness, while keeping direct, indirect, and review-level evidence in separate tiers to avoid cross-domain conflation.", "type": "claim"}, {"id": "claim_4", "text": "Across the corpus, the synthesis supports resistance training as a generally effective strategy for muscle strength and physical function in older adults, with effect sizes that are quantitatively meaningful even when they fall below the 0.1 m/s gait-speed threshold (Perera 2006), but the cardiometabolic, inflammatory, and bone endpoints remain too inconsistent across studies to support universal clinical claims.", "type": "claim"}, {"id": "claim_5", "text": "Interpretation below therefore separates primary clinical-trial evidence from review-level, preclinical, and other indirect evidence.", "type": "claim"}, {"id": "claim_6", "text": "This synthesis evaluates evidence on resistance training effects across 85 included source papers and 5556 high-confidence extracted claims. The review is organized around the distinction between direct interventional hard-endpoint evidence, adjacent/review/context evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty.", "type": "claim"}, {"id": "claim_7", "text": "The corpus contains 31 direct clinical sources, 53 adjacent, review, or context sources, and 1 mechanistic or model-system source. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence.", "type": "claim"}, {"id": "claim_8", "text": "The introductory frame therefore treats the corpus as a set of evidence roles rather than a single directional verdict. Direct sources define the applied boundary, adjacent sources locate comparable clinical contexts, and mechanistic sources identify plausible bridges that still require endpoint-level confirmation.", "type": "claim"}, {"id": "claim_9", "text": "This distinction matters for publication because it makes the paper falsifiable. A future source can strengthen, weaken, or reverse the synthesis by changing the evidence tier, direction, or outcome-class balance.", "type": "claim"}, {"id": "claim_10", "text": "The mechanistic layer is most useful when it explains why a trial signal might appear or fail to appear. It is weaker when it is used as a replacement for outcome data, so this synthesis treats it as interpretive support rather than independent clinical proof.", "type": "claim"}, {"id": "claim_11", "text": "Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection.", "type": "claim"}, {"id": "claim_12", "text": "Adverse or negative signals are likewise retained in the main interpretation. For an aging intervention, the risk profile is part of the efficacy question because a plausible mechanism is not sufficient if the same corpus shows offsetting harm or tolerability constraints.", "type": "claim"}, {"id": "claim_13", "text": "The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific.", "type": "claim"}, {"id": "claim_14", "text": "For that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint.", "type": "claim"}, {"id": "claim_15", "text": "The research value of the synthesis lies in making these boundaries explicit. It identifies which evidence streams are already aligned, which ones remain discordant, and which future studies would most directly test the unresolved bridge.", "type": "claim"}, {"id": "claim_16", "text": "The background evidence for resistance training effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as Lai 2025, Pan 2025, Biersteker 2026 are interpreted separately from mechanistic studies such as Hosseini 2026, because these evidence roles answer different questions about aging biology and clinical translation.", "type": "claim"}, {"id": "claim_17", "text": "The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect.", "type": "claim"}, {"id": "claim_18", "text": "Across the retained sources, positive signals cluster around the muscle function, contextual adjacent evidence and frailty outcome classes; null signals around the muscle function, contextual adjacent evidence, skeletal, fracture, and bone outcome classes; and negative or adverse signals around the muscle function and cardiometabolic outcome classes. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation.", "type": "claim"}, {"id": "claim_19", "text": "The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty.", "type": "claim"}, {"id": "claim_20", "text": "The resulting paper is therefore a calibrated synthesis: it can identify plausible mechanisms, observed direct signals when present, unresolved tensions, and trial-design priorities without converting them into claims stronger than the retained corpus can support.", "type": "claim"}, {"id": "claim_21", "text": "The following fields were extracted from each included source: study design, population / cohort, intervention or exposure, comparator, outcome class, effect direction, effect size, confidence interval or credible interval, p-value, sample size, follow-up duration, risk-of-bias rating. Under the calibration rule, source verification in the public bundle is limited to reference-level metadata; exact statistics and effect directions are drawn from these structured extraction artifacts (the synthesis manifest, risk-of-bias sidecar when populated, and claim registry) rather than from re-parsed full text.", "type": "claim"}, {"id": "claim_22", "text": "Risk-of-bias framework assignment follows study design (RoB-2 for RCTs, ROBINS-I for non-randomised studies, AMSTAR-2 for systematic reviews / meta-analyses). Public appraisal claims are limited to populated `risk_of_bias.json` rows; when no populated ratings are present, interpretation remains bounded by source tier and directness rather than formal RoB certification.", "type": "claim"}, {"id": "claim_23", "text": "Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, contextual adjacent evidence, deficiency prevalence, dosing and pharmacokinetics, frailty, immune and inflammation, muscle function, safety and comorbidity, skeletal, fracture, and bone); within-class agreement, disagreement, and directness gaps surfaced explicitly. Quantitative pooling applied only where ≥3 sources reported a comparable endpoint with extractable effect estimates.", "type": "claim"}, {"id": "claim_24", "text": "Source retrieval, claim extraction, evidence routing, and prose drafting were assisted by large language models under a deterministic audit-trail protocol. Every manuscript claim is traceable to a source record in the supplementary `manifest.json`. Final eligibility and interpretation decisions are author-verified.", "type": "claim"}, {"id": "claim_25", "text": "| Evidence domain | Source | Direction | Directness | Tier | Evidence role | Finding |", "type": "claim"}, {"id": "claim_26", "text": "| Cardiometabolic | Arruda 2026: Risk Factors Associated with Systemic Arterial Hypertension in Postmenopausal Women Engaged in Resistance Training: A Cross-Sectional Observational Study | direction=unclear | directness=indirect | B2 | outcome=Cardiometabolic; direction=unclear | finding=representative statistic P = 0.03; source-level statistic reported |", "type": "claim"}, {"id": "claim_27", "text": "| Cardiometabolic | Costa 2026: Effects of resistance training with/without Photobiomodulation on muscle and respiratory function in difficult-to-control asthma: a randomized trial | direction=unclear | directness=direct | A1 | outcome=Cardiometabolic; direction=unclear | finding=representative non-significant statistic P > 0.05; not treated as positive or negative directional support unless source direction is coded |", "type": "claim"}, {"id": "claim_28", "text": "| Cardiometabolic | Dardashtipour 2026: The effect of aerobic and resistance training in patients with type 2 diabetes on vitamin D (DIAVITEX): a study protocol | direction=null | directness=protocol | D1 | outcome=Cardiometabolic; direction=null | finding=18 extracted claim(s); source-level direction is the coded finding |", "type": "claim"}, {"id": "claim_29", "text": "| Cardiometabolic | MunozPardeza 2026: Effects of Diactive‐1–Supported Progressive Resistance Training on Body Composition in Youth With Type 1 Diabetes | direction=unclear | directness=indirect | B2 | outcome=Cardiometabolic; direction=unclear | finding=representative statistic P < 0.05; source-level statistic reported |", "type": "claim"}, {"id": "claim_30", "text": "| Contextual Adjacent Evidence | Ali 2026: Early Supervised Incremental Resistance Training Versus Standard Care Following Median Sternotomy—A Preliminary Analysis of a Randomized Controlled Trial | direction=null | directness=direct | A1 | outcome=Contextual Adjacent Evidence; direction=null | finding=7 extracted claim(s); source-level direction is the coded finding |", "type": "claim"}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1038/s41598-026-45519-9", "effect": "not extracted", "endpoint": "not extracted", "id": "source_1", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Comparative efficacy of different modes of exercise on inflammatory markers in patients with chronic kidney disease: a systematic review with pairwise and network meta-analyses", "type": "source", "url": "https://doi.org/10.1038/s41598-026-45519-9", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.redox.2025.103972", "effect": "not extracted", "endpoint": "not extracted", "id": "source_2", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Resistance-based training improves mitochondrial capacity and redox balance in aging adults, independent of polyphenol supplementation", "type": "source", "url": "https://doi.org/10.1016/j.redox.2025.103972", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/s12889-026-27418-w", "effect": "not extracted", "endpoint": "not extracted", "id": "source_3", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of exercise on executive function in cognitively healthy older adults: a systematic review and three-level meta-analysis", "type": "source", "url": "https://doi.org/10.1186/s12889-026-27418-w", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s12877-025-06407-5", "effect": "not extracted", "endpoint": "not extracted", "id": "source_4", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of intrinsic foot muscle training combined with the lower extremity resistance training on postural stability in older adults: a randomised controlled trial", "type": "source", "url": "https://doi.org/10.1186/s12877-025-06407-5", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1007/s40520-025-03235-w", "effect": "not extracted", "endpoint": "not extracted", "id": "source_5", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Optimal resistance training prescriptions to improve muscle strength, physical function, and muscle mass in older adults diagnosed with sarcopenia: a systematic review and meta-analysis", "type": "source", "url": "https://doi.org/10.1007/s40520-025-03235-w", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.2147/CIA.S552924", "effect": "not extracted", "endpoint": "not extracted", "id": "source_6", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of Multicomponent Otago Exercise Program with Added Resistance Training on Sarcopenia in Pre-Frailty Older Adults in Nursing Homes: A Randomized Controlled Trial", "type": "source", "url": "https://doi.org/10.2147/CIA.S552924", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.jnha.2026.100838", "effect": "not extracted", "endpoint": "not extracted", "id": "source_7", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effect of a protein intervention during resistance training with varying training intensities on muscle outcomes in frail community-dwelling older adults: a randomized controlled trial", "type": "source", "url": "https://doi.org/10.1016/j.jnha.2026.100838", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/s12877-025-06559-4", "effect": "not extracted", "endpoint": "not extracted", "id": "source_8", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Dose-response effects of resistance training in sarcopenic older adults: systematic review and meta-analysis", "type": "source", "url": "https://doi.org/10.1186/s12877-025-06559-4", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1097/MD.0000000000043976", "effect": "not extracted", "endpoint": "not extracted", "id": "source_9", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of vitamins C and E supplementation combined with 12-week resistance training in older women with sarcopenia: A randomized, double-blind, placebo-controlled trial", "type": "source", "url": "https://doi.org/10.1097/MD.0000000000043976", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.7717/peerj.20778", "effect": "not extracted", "endpoint": "not extracted", "id": "source_10", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of an 8-week liquid protein supplementation on resistance training adaptations in untrained healthy college students", "type": "source", "url": "https://doi.org/10.7717/peerj.20778", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/nu18030504", "effect": "not extracted", "endpoint": "not extracted", "id": "source_11", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of Astragalus membranaceus and Panax notoginseng Saponins Extract on the Pharmacokinetics of Whey Protein Absorption, Intestinal Permeability, and Muscle Function: A Pilot Study", "type": "source", "url": "https://doi.org/10.3390/nu18030504", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1002/jcsm.70162", "effect": "not extracted", "endpoint": "not extracted", "id": "source_12", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Influence of Resistance Training Variables to Improve Muscle Mass Outcomes in Sarcopenia: A Systematic Review With Meta‐Regressions", "type": "source", "url": "https://doi.org/10.1002/jcsm.70162", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s12877-025-06438-y", "effect": "not extracted", "endpoint": "not extracted", "id": "source_13", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of metastable resistance training with strength and balance requirements compared to traditional resistance and balance training on cognitive performance in older adults: a randomized controlled trial", "type": "source", "url": "https://doi.org/10.1186/s12877-025-06438-y", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/nu18101598", "effect": "not extracted", "endpoint": "not extracted", "id": "source_14", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Astragalus membranaceus Modulates Inflammatory Markers Without Enhancing Muscle Function Following Intensified Resistance Training", "type": "source", "url": "https://doi.org/10.3390/nu18101598", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s11556-026-00405-1", "effect": "not extracted", "endpoint": "not extracted", "id": "source_15", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "High-speed resistance training vs. low-speed resistance training on body composition and physical function in adults with sarcopenic obesity", "type": "source", "url": "https://doi.org/10.1186/s11556-026-00405-1", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1113/EP093162", "effect": "not extracted", "endpoint": "not extracted", "id": "source_16", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Acute systemic and energy metabolism responses to velocity‐based resistance training following an oral glucose load in individuals with excess body weight", "type": "source", "url": "https://doi.org/10.1113/EP093162", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1002/ejsc.70202", "effect": "not extracted", "endpoint": "not extracted", "id": "source_17", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of a 4‐Week Multi‐Exercise Isometric Resistance Training Programme on Resting and Ambulatory Blood Pressure in Normotensive Adults", "type": "source", "url": "https://doi.org/10.1002/ejsc.70202", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s12890-025-04035-8", "effect": "not extracted", "endpoint": "not extracted", "id": "source_18", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "The impact of respiratory training on diaphragmatic function in elderly COPD patients with sarcopenia", "type": "source", "url": "https://doi.org/10.1186/s12890-025-04035-8", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41598-026-40482-x", "effect": "not extracted", "endpoint": "not extracted", "id": "source_19", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "High intensity functional training versus traditional resistance training effects on inflammatory, metabolic, and physical outcomes in overweight men a randomized controlled trial", "type": "source", "url": "https://doi.org/10.1038/s41598-026-40482-x", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fcvm.2026.1843543", "effect": "not extracted", "endpoint": "not extracted", "id": "source_20", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of dynamic resistance training on blood pressure across different baseline levels: a systematic review and meta-analysis", "type": "source", "url": "https://doi.org/10.3389/fcvm.2026.1843543", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1001/jamanetworkopen.2025.16772", "effect": "not extracted", "endpoint": "not extracted", "id": "source_21", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Weighted Vest Use or Resistance Exercise to Offset Weight Loss–Associated Bone Loss in Older Adults", "type": "source", "url": "https://doi.org/10.1001/jamanetworkopen.2025.16772", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s12877-025-06355-0", "effect": "not extracted", "endpoint": "not extracted", "id": "source_22", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "36-Week personalized resistance training improves muscle function and circulating myokines in older women with possible sarcopenic obesity: a randomized clinical trial", "type": "source", "url": "https://doi.org/10.1186/s12877-025-06355-0", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3389/fspor.2025.1705675", "effect": "not extracted", "endpoint": "not extracted", "id": "source_23", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of different lifting strategies during resistance training on lower body function in untrained adult women: a comparison between 6-weeks of 10% velocity loss and standard resistance training", "type": "source", "url": "https://doi.org/10.3389/fspor.2025.1705675", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3389/fmed.2021.702436", "effect": "not extracted", "endpoint": "not extracted", "id": 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"directness": "primary", "doi": "10.26603/001c.147897", "effect": "not extracted", "endpoint": "not extracted", "id": "source_26", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Perceived Exertion, Neuromuscular Activation, and Training Volume in Older Adults: Validating RPE-1 in Moderate-Velocity Elastic Band Resistance Training", "type": "source", "url": "https://doi.org/10.26603/001c.147897", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1002/alz.71245", "effect": "not extracted", "endpoint": "not extracted", "id": "source_27", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Resistance training and subcortical vascular cognitive impairment: A 12‐month randomized trial", "type": "source", "url": "https://doi.org/10.1002/alz.71245", "year": 2026}, {"comparator": "not 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"endpoint": "not extracted", "id": "source_68", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "A pilot randomized trial of supervised resistance training plus home-based activity in chronic lymphocytic leukaemia patients", "type": "source", "url": "https://doi.org/10.1038/s41598-026-38721-2", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s12877-026-07464-0", "effect": "not extracted", "endpoint": "not extracted", "id": "source_69", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of low-load resistance training with blood flow restriction and swallowing training on sarcopenic dysphagia in community-dwelling older people in China: a randomised controlled trial protocol", "type": "source", "url": "https://doi.org/10.1186/s12877-026-07464-0", "year": 2026}, 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Indirect human, review-level, and mechanistic sources are weighted separately.", "type": "source", "url": null, "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_88", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "**Directional signal** is counted within the assigned outcome class only. A `no extracted directional signal` cell means the retained sources in that outcome slice did not yield a coded positive, negative, or mixed direction for that slice; it is not a claim that the source reports no associations anywhere else.", "type": "source", "url": null, "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_89", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "**Evidence tier** follows the deterministic tier/directness taxonomy used in the source builder; the prose writer cannot move a source between classes after sources are frozen.", "type": "source", "url": null, "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": "10.1111/j.1532-5415.2006.00701.x", "effect": "not extracted", "endpoint": "not extracted", "id": "source_90", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Perera 2006", "type": "source", "url": "https://doi.org/10.1111/j.1532-5415.2006.00701.x", "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": "10.1371/journal.pmed.0020124", "effect": "not extracted", "endpoint": "not extracted", "id": "source_91", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Ioannidis 2005", "type": "source", "url": "https://doi.org/10.1371/journal.pmed.0020124", "year": null}], "publication_id": "a7d2fa80-23dd-4c69-b863-df035c479906", "screening": {"excluded": 0, "exclusion_reasons": ["No PRISMA full-text exclusion-stage filter was applied."], "flow": ["identified", "screened", "excluded_with_reasons", "included"], "identified": 85, "included": 85, "included_or_retained": 85, "screened": 85, "wording": "85 candidate receipts retained after source retrieval, deduplication, and topic filtering. 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