Derivation Web

source_3ce8d25d5d0e48da

by researka:v2 · 2026-06-09 01:11:58.501614+04:00

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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_5", "text": "The thesis is: Across 16 curated reference papers, the evidence base for Semaglutide Biomarker Effects shows a context-dependent profile. Positive signals appear in: cardiometabolic, contextual other. Null findings dominate: cardiometabolic, contextual other. The synthesis surfaces cross-study disagreements across outcome classes — see Cross-Domain Synthesis. The Semaglutide Biomarker Effects anti-aging case as currently constituted is incomplete: mechanistic plausibility coexists with mixed or sparse human-RCT evidence, and the boundary conditions remain to be established. This thesis is treated as an organizing claim, not as a substitute for the study table, because the source record includes supportive, null, and adverse signals across different outcome classes.", "type": "claim"}, {"id": "claim_6", "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_7", "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_8", "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_9", "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_10", "text": "Evidence-honesty note: 13/16 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims.", "type": "claim"}, {"id": "claim_11", "text": "This paper synthesizes evidence on semaglutide biomarker effects across 16 included source papers and 1549 high-confidence extracted claims.", "type": "claim"}, {"id": "claim_12", "text": "The evidence profile contains 3 direct clinical sources, 9 adjacent clinical sources, and no sources classified primarily as mechanistic or model-system evidence, with 46 cross-study disagreements across the evidence base.", "type": "claim"}, {"id": "claim_13", "text": "Positive study-level signals are summarized in the cardiometabolic and contextual adjacent evidence outcome classes, null signals in the cardiometabolic and contextual adjacent evidence outcome classes, and negative signals in no dominant outcome class. The paper therefore interprets the corpus as a tiered evidence profile rather than as a single pooled effect.", "type": "claim"}, {"id": "claim_14", "text": "The conclusion is that semaglutide biomarker effects should be treated as a bounded geroscience hypothesis: the retained clinical and adjacent evidence profile defines the scope for targeted testing, while mixed and null findings limit any unqualified anti-aging claim.", "type": "claim"}, {"id": "claim_15", "text": "This synthesis evaluates evidence on semaglutide biomarker effects across 16 included source papers and 1549 high-confidence extracted claims.", "type": "claim"}, {"id": "claim_16", "text": "The research question is interpreted through design, population, and endpoint boundaries. Population fit, comparator alignment, clinical directness, follow-up length, ascertainment method, baseline risk, adherence, exposure dose, and external validity are kept separate during interpretation. The interpretation", "type": "claim"}, {"id": "claim_17", "text": "The research question is interpreted through design, population, and endpoint boundaries. Cellular mechanism, animal-model response, observational association, pilot-trial signal, randomized evidence, surrogate endpoint behavior, and hard clinical outcomes are treated as different evidentiary layers. The interpretation", "type": "claim"}, {"id": "claim_18", "text": "Preclinical and disease-model studies have provided the mechanistic rationale for investigating Semaglutide Biomarker Effects as a potential geroprotector. GLP-1 receptor activation modulates key nutrient-sensing pathways, including AMPK and mTOR, which are central to the regulation of autophagy, mitochondrial function, and cellular senescence—hallmarks directly implicated in aging biology (Arslanian 2025). In rodent models of obesity and metabolic syndrome, semaglutide and related GLP-1RAs reduce hepatic steatosis, improve insulin sensitivity, and attenuate inflammatory cytokine production, effects that parallel interventions known to extend healthspan in preclinical systems (Mulvagh 2026). Furthermore, semaglutide has demonstrated neuroprotective properties in animal models of neurodegeneration, potentially mediated through reductions in neuroinflammation and improvements in cerebral glucose metabolism, though translation to human cognitive endpoints remains poorly characterized (Hamarsheh 2026). Evidence from the SELECT trial prespecified analysis suggests semaglutide may influence liver fibrosis and cardiac remodeling pathways, with significant reductions in fibrosis biomarkers observed versus placebo (Meyhofer 2026). These mechanistic signals suggest that Semaglutide Biomarker Effects may operate through conserved aging pathways, though the preclinical evidence base is heterogeneous and the dose-response relationships in human aging contexts remain to be systematically characterized.", "type": "claim"}, {"id": "claim_19", "text": "The clinical-trial landscape for Semaglutide Biomarker Effects is anchored by several large-scale randomized controlled trials, though these were primarily designed for cardiometabolic endpoints rather than geroprotective outcomes. The STEP clinical trial program, including STEP TEENS (NCT04102189), has established semaglutide's efficacy for weight reduction across diverse populations, with the STEP TEENS secondary analysis documenting significant improvements in insulin sensitivity in adolescents (Arslanian 2025). Network meta-analyses comparing GLP-1RA-based therapies indicate that semaglutide produces clinically meaningful weight loss, though comparative effectiveness data with newer agents like tirzepatide and cagriSema show overlapping confidence intervals and context-dependent efficacy profiles (Hamarsheh 2026). Real-world evaluations, including the SEMASEARCH study protocol, seek to generate evidence in populations underrepresented in pivotal trials, particularly those with severe obesity and complex multimorbidity (Lassen 2026). Emerging trial protocols also explore semaglutide repurposing for addiction, including cigarette use reduction (Hendershot 2026) and cocaine use disorder (Yammine 2026), suggesting broad neurobiological activity beyond metabolic pathways.", "type": "claim"}, {"id": "claim_20", "text": "Critical methodological questions surround the interpretation and synthesis of Semaglutide Biomarker Effects evidence for geroprotective claims. Endpoint selection remains a fundamental challenge: most available trials employ cardiometabolic surrogates such as HbA1c, body weight, and lipid profiles rather than validated aging biomarkers or hard clinical endpoints like all-cause mortality, physical function decline, or frailty onset (Cortes 2024). The reliance on surrogate endpoints introduces interpretive uncertainty, as surrogate associations do not guarantee hard-outcome validity (Ioannidis 2005). Heterogeneity across study designs—spanning randomized controlled trials (Ganeshalingam 2026, Meyhofer 2026), observational cohorts (Wilson 2026, Mulvagh 2026), network meta-analyses (Hamarsheh 2026), and systematic reviews (Gadelmawla 2026, Sass 2026)—complicates direct comparison and pooled inference. The tension between positive signals in cardiometabolic contexts and null or mixed findings in other outcome classes, as documented across cross-study disagreements in the evidence base, underscores that the Semaglutide Biomarker Effects anti-aging case is context-dependent rather than generalizable. Concurrent interventions, including behavioral modification, dietary counseling, and exercise programs co-administered in most clinical trials, confound attribution of observed biomarker changes to semaglutide alone. Furthermore, populations studied—predominantly middle-aged adults with obesity or type 2 diabetes—may not be representative of the broader aging population in which geroprotective interventions would ideally be deployed, limiting external validity. Addressing these methodological gaps will require dedicated geroscience-designed trials incorporating validated aging biomarkers (e.g., epigenetic clocks, inflammatory panels, functional assessments), extended follow-up periods, and inclusion of older adults with multimorbidity to establish whether Semaglutide Biomarker Effects represent a genuine geroprotective opportunity or primarily reflect metabolic disease management.", "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 appraisal, and claim registry) rather than from re-parsed full text.", "type": "claim"}, {"id": "claim_22", "text": "Per-source risk-of-bias was rated using design-appropriate Cochrane RoB-2 (RCTs), ROBINS-I (non-randomised studies), and AMSTAR-2 (systematic reviews / meta-analyses). Ratings recorded in `risk_of_bias.json`.", "type": "claim"}, {"id": "claim_23", "text": "Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, contextual adjacent evidence, 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": "Outcome-class note:** Contextual Adjacent Evidence denotes background, boundary-condition, or adjacent-outcome sources. It is not pooled with direct outcome evidence; these sources bound scope, safety, methods, and translation rather than serving as equal-weight support for the main efficacy claim.", "type": "claim"}, {"id": "claim_26", "text": "| Evidence domain | Corpus slice | Strongest signal | Directness | Main limitation |", "type": "claim"}, {"id": "claim_27", "text": "| Contextual Adjacent Evidence | n=9; claims=1148 | mixed signal in 4/9 sources | 1 direct; 6 indirect; 2 review | limited corpus depth in this outcome class |", "type": "claim"}, {"id": "claim_28", "text": "Contextual Adjacent Evidence: n=9; claims=1148; mixed signal in 4/9 sources | directness: 1 direct; 6 indirect; 2 review; main limitation: directionally heterogeneous.", "type": "claim"}, {"id": "claim_29", "text": "The evidence base for semaglutide's cardiometabolic biomarker effects encompasses a range of study designs and populations. Ganeshalingam 2026 reported a dose of 1.0 mg. The STEP TEENS study (Arslanian 2025), a secondary analysis of the NCT04102189 cohort, examined effects in adolescents with obesity. Real-world evidence is represented by the SEMASEARCH study design (Lassen 2026), which aims to evaluate semaglutide 2.4 mg in adults with severe obesity underrepresented in trials.", "type": "claim"}, {"id": "claim_30", "text": "Mechanistically, the observed improvements in insulin sensitivity and β-cell function (Ganeshalingam 2026) align with the known pharmacology of GLP-1 receptor agonists, which enhance glucose-dependent insulin secretion and suppress glucagon. The significant HbA1c reduction documented in the meta-analysis (Sass 2026) provides a direct clinical correlate to these mechanistic actions. Preclinical and pathway-level data suggest that weight loss, a primary effect of semaglutide, is a major driver of improved cardiometabolic biomarkers, a relationship evident in the adolescent cohort (Arslanian 2025). However, the protocol for the older adult RCT (Cortes 2024) also highlights an investigation into biomarkers of aging, suggesting a potential mechanism beyond simple weight reduction involving direct metabolic and anti-inflammatory pathways.", "type": "claim"}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41591-026-04204-0", "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": "Bimagrumab plus semaglutide alone or in combination for the treatment of obesity: a randomized phase 2 trial", "type": "source", "url": "https://doi.org/10.1038/s41591-026-04204-0", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1002/edm2.70248", "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": "Comparative Effectiveness of CagriSegma , Semaglutide, Cagrilintide and Tirzepatide in the Management of Overweight and Obesity: A Network Meta‐Analysis of Randomized Clinical Trials", "type": "source", "url": "https://doi.org/10.1002/edm2.70248", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.2337/dc25-0824", "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": "Effect of Semaglutide on Insulin Sensitivity and Cardiometabolic Risk Factors in Adolescents With Obesity: The STEP TEENS Study", "type": "source", "url": "https://doi.org/10.2337/dc25-0824", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1001/jamacardio.2026.0245", "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": "Oral Semaglutide and Change in Cardiovascular Risk Factors in High-Risk Type 2 Diabetes", "type": "source", "url": "https://doi.org/10.1001/jamacardio.2026.0245", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41591-026-04281-1", "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": "Semaglutide on liver fibrosis and heart outcomes in patients at high risk of liver fibrosis: a prespecified analysis of the SELECT randomized trial", "type": "source", "url": "https://doi.org/10.1038/s41591-026-04281-1", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1093/eurheartj/ehaf690", "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": "Semaglutide promotes bone marrow–derived progenitor cell flux towards an anti-inflammatory and pro-regenerative profile in high-risk patients: the SEMA-VR CardioLink-15 trial", "type": "source", "url": "https://doi.org/10.1093/eurheartj/ehaf690", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.2337/dc25-2041", "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": "Semaglutide Effects on Insulin Sensitivity and β-Cell Function in Patients With Schizophrenia, Prediabetes, and Obesity Treated With Second-Generation Antipsychotics: Findings From the HISTORI Trial, a 30-Week Randomized, Placebo-Controlled Trial With Semaglutide 1.0 mg Weekly", "type": "source", "url": "https://doi.org/10.2337/dc25-2041", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1111/dom.70436", "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": "Semaglutide and tirzepatide effects on cardiovascular outcomes in people with overweight or obesity in the real world ( STEER )", "type": "source", "url": "https://doi.org/10.1111/dom.70436", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1371/journal.pmed.1005064", "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": "Semaglutide-associated risk of nonarteritic anterior ischemic optic neuropathy in patients with type 2 diabetes: A systematic review and meta-analysis of observational studies", "type": "source", "url": "https://doi.org/10.1371/journal.pmed.1005064", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.2196/62667", "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": "Effect of Semaglutide on Physical Function, Body Composition, and Biomarkers of Aging in Older Adults With Overweight and Insulin Resistance: Protocol for an Open-Labeled Randomized Controlled Trial", "type": "source", "url": "https://doi.org/10.2196/62667", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1001/jamanetworkopen.2026.14898", "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": "Once-Weekly Semaglutide in Adults With Daily Cigarette Use", "type": "source", "url": "https://doi.org/10.1001/jamanetworkopen.2026.14898", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1136/bmjopen-2025-115675", "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": "Repurposing semaglutide as an adjunctive treatment for cocaine use disorder: protocol for a randomised controlled trial", "type": "source", "url": "https://doi.org/10.1136/bmjopen-2025-115675", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1111/dom.70697", "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": "SEMASEARCH Study Design: Real‐World Evaluation of Semaglutide 2.4 mg in Adults With Severe Obesity Underrepresented in Clinical Trials", "type": "source", "url": "https://doi.org/10.1111/dom.70697", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1001/jamapsychiatry.2025.3639", "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": "Semaglutide and Early-Stage Metabolic Abnormalities in Individuals With Schizophrenia Spectrum Disorders: A Randomized Clinical Trial.", "type": "source", "url": "https://doi.org/10.1001/jamapsychiatry.2025.3639", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fmed.2026.1764664", "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": "Tirzepatide vs. semaglutide for obesity, glycemic control, and cardiovascular outcomes: a narrative review of clinical trials", "type": "source", "url": "https://doi.org/10.3389/fmed.2026.1764664", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1016/j.amjcard.2026.02.030", "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": "CagriSema Versus Semaglutide Monotherapy or Placebo for Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with GRADE Assessment.", "type": "source", "url": "https://doi.org/10.1016/j.amjcard.2026.02.030", "year": 2026}, {"comparator": "not extracted", "directness": "citation", "doi": null, "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": "**Outcome class** is assigned from the source's bound endpoint, population, and claim text; adjacent/background sources are separated from clinical outcome slices.", "type": "source", "url": null, "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": null, "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": "**Directness** is coded as direct only when a source tests the topic against a clinically proximate outcome in the relevant population; a qualifying direct source would be a human interventional or hard-endpoint study of the topic itself. 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_19", "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_20", "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": "10.1001/jama.2010.1923", "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": "Studenski 2011", "type": "source", "url": "https://doi.org/10.1001/jama.2010.1923", "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": "10.1111/j.1532-5415.2006.00701.x", "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": "Perera 2006", "type": "source", "url": "https://doi.org/10.1111/j.1532-5415.2006.00701.x", "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": "10.2337/dc24-S006", "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": "ADA 2024", "type": "source", "url": "https://doi.org/10.2337/dc24-S006", "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_24", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "WHO 2000", "type": "source", "url": null, "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": "10.1093/ageing/afy169", "effect": "not extracted", "endpoint": "not extracted", "id": "source_25", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Cruz-Jentoft 2019", "type": "source", "url": "https://doi.org/10.1093/ageing/afy169", "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": null, "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": "Anisimov 2008", "type": "source", "url": null, "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": "10.1056/NEJMoa1504347", "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": "Tancredi 2015", "type": "source", "url": "https://doi.org/10.1056/NEJMoa1504347", "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": "10.1136/bmj.c332", "effect": "not extracted", "endpoint": "not extracted", "id": "source_28", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Schulz 2010", "type": "source", "url": "https://doi.org/10.1136/bmj.c332", "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": "10.1371/journal.pmed.0020124", "effect": "not extracted", "endpoint": "not extracted", "id": "source_29", "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": "3d14b1df-ee4d-403d-8542-096906fcf3f0", "screening": {"excluded": 0, "exclusion_reasons": ["No PRISMA full-text exclusion-stage filter was applied."], "flow": ["identified", "screened", "excluded_with_reasons", "included"], "identified": 16, "included": 16, "included_or_retained": 16, "screened": 16, "wording": "16 candidate receipts retained after source retrieval, deduplication, and topic filtering. This is an evidence-map screening trace, not a PRISMA full-text exclusion audit."}}

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