source · application/json
source_e06fe623105f4b1d
sha256 5093f0a98cbe4df4e0a4812c9b5792f2d6625dd8233528638247e98a0943d821
by researka:v2 · 2026-07-04 10:16:45.885411+04:00
{"content_hash": "sha256:662eb75607bfdba01b29302e8bca263d99248e5a98ade3e9779acb2a7d232262", "edges": [{"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_1", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_2", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_3", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_4", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_5", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_6", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_7", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_8", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_9", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_10", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_11", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_12", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_13", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_14", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_15", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_16", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_17", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_18", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_19", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_20", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_21", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_22", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_23", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_24", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_25", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_26", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_27", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_28", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_29", "type": "contains_claim"}, {"from": "145fcccc-2360-4120-8674-34dd3e97ade7", "to": "claim_30", "type": "contains_claim"}], "nodes": [{"id": "145fcccc-2360-4120-8674-34dd3e97ade7", "title": "Adjacent Evidence Brief: Aspirin Use Effects — full paper", "type": "publication"}, {"id": "claim_1", "text": "Evidence-honesty note: The retained evidence has no direct interventional hard-endpoint evidence; indirect, review-level, adjacent, or mechanistic sources are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims.", "type": "claim"}, {"id": "claim_2", "text": "We conducted an AI-assisted structured evidence synthesis across 55 curated reference papers indexed for Aspirin, extracting effect estimates, confidence intervals, and p-values into an audit-trailed evidence table while preserving the design and directness annotations supplied by the original sources.", "type": "claim"}, {"id": "claim_3", "text": "Safety signals include increased intracerebral hemorrhage when aspirin was combined with severe hypertension (P = 0.003), whereas aspirin exposure was associated with lower severe AKI incidence in MIMIC-IV/eICU sepsis cohorts (P < 0.001), illustrating outcome- and population-dependent benefit–risk tradeoffs.", "type": "claim"}, {"id": "claim_4", "text": "Across outcome classes, cross-study disagreements emerged in the synthesis — most prominently null-versus-positive conflicts on contextual outcomes (Sun 2019 vs Alabsi 2023; Wang 2021a vs Huff 2025) and on longevity outcomes in specific subgroups (Wu 2024, Xu 2026, Chow 2022 vs Celik 2018) — confirming that aspirin's effect profile is context-dependent rather than uniformly beneficial.", "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 aspirin use effects across 55 included source papers and 2311 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 no sources classified primarily as direct interventional hard-endpoint evidence, 55 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence. 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 aspirin use effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as the retained evidence base are interpreted separately from mechanistic studies such as the retained evidence base, 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 longevity, contextual adjacent evidence, safety and comorbidity outcome classes; null signals around the contextual adjacent evidence, deficiency prevalence and cardiometabolic outcome classes; and negative or adverse signals around no dominant outcome class. 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, immune and inflammation, longevity, mortality and survival, safety and comorbidity); 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": "| Aspirin Use Effects / Contextual Adjacent Evidence | n=23; claims=984 | significant source statistic in 16/23 sources; receipt-level direction coded unclear | 14 indirect; 9 review | limited corpus depth in this outcome class |", "type": "claim"}, {"id": "claim_28", "text": "| Aspirin Use Effects / Cardiometabolic | n=1; claims=81 | significant source statistic in 1/1 sources; receipt-level direction coded null | 1 indirect | single-source slice; hypothesis-generating |", "type": "claim"}, {"id": "claim_29", "text": "Contextual Adjacent Evidence: n=23; claims=984; mixed signal in 15/23 sources | directness: 14 indirect; 9 review; main limitation: no direct clinical anchor.", "type": "claim"}, {"id": "claim_30", "text": "The cardiometabolic evidence base for aspirin use in primary prevention is anchored by one observational cohort study, Huang 2024, which characterizes US population eligibility rather than incident events. The study identifies the proportion of US adults 40–59 years who meet USPSTF criteria for primary prevention aspirin, framing the upstream public-health denominator before any effect-size analysis is attempted. By design, this is an epidemiologic estimation paper, so the canonical endpoint is prevalence of eligibility rather than a hazard ratio for a clinical outcome. The full numeric anchor is reported in the evidence synthesis alongside any per-study effect estimate where available.", "type": "claim"}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/s12885-020-07117-4", "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": "Relationship between aspirin use of esophageal, gastric and colorectal cancer patient survival: a meta-analysis", "type": "source", "url": "https://doi.org/10.1186/s12885-020-07117-4", "year": 2020}, {"comparator": "not extracted", "directness": "primary", "doi": "10.5152/AnatolJCardiol.2021.541", "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": "An Evaluation of Aspirin Treatment Preferences of Physicians in Hypertensive Patients in Terms of Current Guidelines: A Subgroup Analysis of the ASSOS Trial in Turkey", "type": "source", "url": "https://doi.org/10.5152/AnatolJCardiol.2021.541", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3389/fonc.2021.633462", "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": "Can Aspirin Use Be Associated With the Risk or Prognosis of Bladder Cancer? A Case-Control Study and Meta-analytic Assessment", "type": "source", "url": "https://doi.org/10.3389/fonc.2021.633462", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1001/jamanetworkopen.2022.3890", "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": "Association of Early Aspirin Use With In-Hospital Mortality in Patients With Moderate COVID-19", "type": "source", "url": "https://doi.org/10.1001/jamanetworkopen.2022.3890", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41523-025-00775-2", "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": "Regular aspirin use, breast tumor characteristics and long-term breast cancer survival", "type": "source", "url": "https://doi.org/10.1038/s41523-025-00775-2", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1093/oncolo/oyad186", "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": "Aspirin Use and Survival Among Patients With Breast Cancer: A Systematic Review and Meta-Analysis", "type": "source", "url": "https://doi.org/10.1093/oncolo/oyad186", "year": 2023}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1093/jncics/pkab067", "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": "Timing of Aspirin Use Among Patients With Colorectal Cancer in Relation to Mortality: A Systematic Review and Meta-Analysis", "type": "source", "url": "https://doi.org/10.1093/jncics/pkab067", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fonc.2021.690219", "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": "Aspirin Use and Common Cancer Risk: A Meta-Analysis of Cohort Studies and Randomized Controlled Trials", "type": "source", "url": "https://doi.org/10.3389/fonc.2021.690219", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.ajpc.2021.100256", "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": "Aspirin for cardiovascular disease prevention among adults in the United States: Trends, prevalence, and participant characteristics associated with use", "type": "source", "url": "https://doi.org/10.1016/j.ajpc.2021.100256", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.ajpc.2024.100669", "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": "US population qualifying for aspirin use for primary prevention of cardiovascular disease", "type": "source", "url": "https://doi.org/10.1016/j.ajpc.2024.100669", "year": 2024}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1136/bmjopen-2021-048719", "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": "Impact of aspirin use on clinical outcomes in patients with vasospastic angina: a systematic review and meta-analysis", "type": "source", "url": "https://doi.org/10.1136/bmjopen-2021-048719", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1002/hep4.1640", "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": "Aspirin Use Is Associated with a Reduced Incidence of Hepatocellular Carcinoma: A Systematic Review and Meta‐analysis", "type": "source", "url": "https://doi.org/10.1002/hep4.1640", "year": 2020}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fonc.2020.575831", "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": "Aspirin Use and Mortality in Women With Ovarian Cancer: A Meta-Analysis", "type": "source", "url": "https://doi.org/10.3389/fonc.2020.575831", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1007/s10552-021-01472-8", "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": "Medication use and risk of proximal colon cancer: a systematic review of prospective studies with narrative synthesis and meta-analysis", "type": "source", "url": "https://doi.org/10.1007/s10552-021-01472-8", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1111/jch.14091", "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": "Association between aspirin use and cardiovascular outcomes in ALLHAT participants with and without chronic kidney disease: A post hoc analysis", "type": "source", "url": "https://doi.org/10.1111/jch.14091", "year": 2020}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1002/cam4.4859", "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": "Low‐dose aspirin use and colorectal cancer survival in 32,195 patients—A national cohort study", "type": "source", "url": "https://doi.org/10.1002/cam4.4859", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1097/MD.0000000000026870", "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": "Effect of aspirin use on survival benefits of breast cancer patients", "type": "source", "url": "https://doi.org/10.1097/MD.0000000000026870", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fnagi.2020.578071", "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": "Aspirin Use on Incident Dementia and Mild Cognitive Decline: A Systematic Review and Meta-Analysis", "type": "source", "url": "https://doi.org/10.3389/fnagi.2020.578071", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.12998/wjcc.v11.i32.7814", "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": "Efficacy and safety of aspirin antiplatelet therapy within 48 h of symptom onset in patients with acute stroke", "type": "source", "url": "https://doi.org/10.12998/wjcc.v11.i32.7814", "year": 2023}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.ajpc.2024.100674", "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": "Aspirin use for primary prevention among US adults with and without elevated Lipoprotein(a)", "type": "source", "url": "https://doi.org/10.1016/j.ajpc.2024.100674", "year": 2024}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fmed.2020.569759", "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": "Aspirin Use and the Incidence of Hepatocellular Carcinoma in Patients With Hepatitis B Virus or Hepatitis C Virus Infection: A Meta-Analysis of Cohort Studies", "type": "source", "url": "https://doi.org/10.3389/fmed.2020.569759", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s12933-025-02802-9", "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": "Daily low dose aspirin halves incident type 2 diabetes in elderly subjects with prediabetes: a five-year longitudinal cohort study in a real-word population", "type": "source", "url": "https://doi.org/10.1186/s12933-025-02802-9", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1080/0886022X.2025.2568650", "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": "Aspirin use is associated with attenuated risk of severe acute kidney injury in septic patients: a dual-center retrospective analysis from MIMIC-IV and eICU cohorts", "type": "source", "url": "https://doi.org/10.1080/0886022X.2025.2568650", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s13148-025-01988-9", "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": "Analysis of prenatal medication use and placental epigenetic gestational age in extremely low gestational age newborns (ELGANs) highlight relationships to aspirin use during pregnancy", "type": "source", "url": "https://doi.org/10.1186/s13148-025-01988-9", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1097/MD.0000000000021917", "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": "Aspirin might reduce the incidence of breast cancer", "type": "source", "url": "https://doi.org/10.1097/MD.0000000000021917", "year": 2020}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fphar.2022.824745", "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": "Association Between Aspirin Usage and Age-Related Macular Degeneration: An Updated Systematic Review and Meta-analysis", "type": "source", "url": "https://doi.org/10.3389/fphar.2022.824745", "year": 2022}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1016/j.ahjo.2022.100191", "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": "Aspirin use is associated with decreased inpatient mortality in patients with COVID-19: A meta-analysis", "type": "source", "url": "https://doi.org/10.1016/j.ahjo.2022.100191", "year": 2022}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fphar.2022.989903", "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": "Associations between the use of aspirin or other antiplatelet drugs and all-cause mortality among patients with COVID-19: A meta-analysis", "type": "source", "url": "https://doi.org/10.3389/fphar.2022.989903", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3389/fnagi.2025.1603892", "effect": "not 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"effect": "not extracted", "endpoint": "not extracted", "id": "source_31", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Inappropriate Use of Aspirin in Real-Life Cardiology Practice: Results from the Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study (ASSOS) Study", "type": "source", "url": "https://doi.org/10.5152/balkanmedj.2021.21143", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.pmedr.2023.102571", "effect": "not extracted", "endpoint": "not extracted", "id": "source_32", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Regular aspirin use among a sample of American Indians/Alaskan Natives in the Upper Midwest region of the United States", "type": "source", "url": "https://doi.org/10.1016/j.pmedr.2023.102571", "year": 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appraised in public sidecar", "study": "Continuous aspirin treatment improves cardiovascular events and all-cause mortality in hemodialysis patients with peripheral artery disease", "type": "source", "url": "https://doi.org/10.1080/0886022X.2024.2380754", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.34172/jcvtr.33184", "effect": "not extracted", "endpoint": "not extracted", "id": "source_39", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Impact of prior aspirin use on left ventricular function in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: An echocardiographic evaluation", "type": "source", "url": "https://doi.org/10.34172/jcvtr.33184", "year": 2024}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1111/ene.15433", "effect": "not extracted", "endpoint": "not extracted", "id": "source_40", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Does prior use of antiplatelet therapy modify the effect of dual antiplatelet therapy in transient ischaemic attack/minor ischaemic stroke: A systematic review and meta‐analysis", "type": "source", "url": "https://doi.org/10.1111/ene.15433", "year": 2022}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/s40246-024-00699-1", "effect": "not extracted", "endpoint": "not extracted", "id": "source_41", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "The associations of candidate gene polymorphisms with aspirin resistance in patients with ischemic disease: a meta-analysis", "type": "source", "url": "https://doi.org/10.1186/s40246-024-00699-1", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.22603/ssrr.2022-0163", "effect": "not extracted", "endpoint": "not extracted", "id": "source_42", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Safety of Continuing Aspirin Use in Cervical Laminoplasty: A Propensity Score-Matched Analysis", "type": "source", "url": "https://doi.org/10.22603/ssrr.2022-0163", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41598-025-08075-2", "effect": "not extracted", "endpoint": "not extracted", "id": "source_43", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Aspirin improves short and long term survival outcomes of patients with sepsis associated encephalopathy", "type": "source", "url": "https://doi.org/10.1038/s41598-025-08075-2", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1093/geroni/igab046.2339", "effect": "not extracted", "endpoint": "not extracted", "id": "source_44", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults.", "type": "source", "url": "https://doi.org/10.1093/geroni/igab046.2339", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1016/j.clbc.2021.02.005", "effect": "not extracted", "endpoint": "not extracted", "id": "source_45", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Aspirin Use and Risk of Breast Cancer: A Meta-analysis of Observational Studies from 1989 to 2019.", "type": "source", "url": "https://doi.org/10.1016/j.clbc.2021.02.005", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1016/j.clinre.2020.09.006", "effect": "not extracted", "endpoint": "not extracted", "id": "source_46", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Influence of aspirin use on clinical outcomes of patients with hepatocellular carcinoma: a meta-analysis.", "type": "source", "url": "https://doi.org/10.1016/j.clinre.2020.09.006", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1213/ane.0000000000005292", "effect": "not extracted", "endpoint": "not extracted", "id": "source_47", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019.", "type": "source", "url": "https://doi.org/10.1213/ane.0000000000005292", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1101/2022.08.03.22278392", "effect": "not extracted", "endpoint": "not extracted", "id": "source_48", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Association of mortality and aspirin use for COVID-19 residents at VA Community Living Center Nursing Homes", "type": "source", "url": "https://doi.org/10.1101/2022.08.03.22278392", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.ajpc.2021.100281", "effect": "not extracted", "endpoint": "not extracted", "id": "source_49", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Shared decision making and patient reported outcomes among adults with atherosclerotic cardiovascular disease, medical expenditure panel survey 2006–2015", "type": "source", "url": "https://doi.org/10.1016/j.ajpc.2021.100281", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1093/pubmed/fdz114", "effect": "not extracted", "endpoint": "not extracted", "id": "source_50", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Low-dose aspirin use and cancer-specific mortality: a meta-analysis of cohort studies.", "type": "source", "url": "https://doi.org/10.1093/pubmed/fdz114", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.14283/jfa.2024.37", "effect": "not extracted", "endpoint": "not extracted", "id": "source_51", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Inflammation, Frailty, and Aspirin Use in the Physicians' Health Study: A Pilot Study.", "type": "source", "url": "https://doi.org/10.14283/jfa.2024.37", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1097/MD.0000000000018033", "effect": "not extracted", "endpoint": "not extracted", "id": "source_52", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Aspirin use and pancreatic cancer risk", "type": "source", "url": "https://doi.org/10.1097/MD.0000000000018033", "year": 2019}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s12933-019-0875-4", "effect": "not extracted", "endpoint": "not extracted", "id": "source_53", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Aspirin has potential benefits for primary prevention of cardiovascular outcomes in diabetes: updated literature-based and individual participant data meta-analyses of randomized controlled trials", "type": "source", "url": "https://doi.org/10.1186/s12933-019-0875-4", "year": 2019}, {"comparator": "not extracted", "directness": "primary", "doi": "10.14744/AnatolJCardiol.2018.47587", "effect": "not extracted", "endpoint": "not extracted", "id": "source_54", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Design and rationale for the ASSOS study: Appropriateness of aspirin use in medical outpatients a multicenter and observational study", "type": "source", "url": "https://doi.org/10.14744/AnatolJCardiol.2018.47587", "year": 2018}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1371/journal.pone.0185847", "effect": "not extracted", "endpoint": "not extracted", "id": "source_55", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Reduction of intracerebral hemorrhage in hemodialysis patients after reducing aspirin use: A quality-assurance observational study", "type": "source", "url": "https://doi.org/10.1371/journal.pone.0185847", "year": 2017}, {"comparator": "not extracted", "directness": "citation", "doi": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_56", "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_57", "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_58", "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_59", "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_60", "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": "10.1093/ageing/afy169", "effect": "not extracted", "endpoint": "not extracted", "id": "source_61", "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": "10.1371/journal.pmed.0020124", "effect": "not extracted", "endpoint": "not extracted", "id": "source_62", "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": "145fcccc-2360-4120-8674-34dd3e97ade7", "screening": {"excluded": 0, "exclusion_reasons": ["No PRISMA full-text exclusion-stage filter was applied."], "flow": ["identified", "screened", "excluded_with_reasons", "included"], "identified": 55, "included": 55, "included_or_retained": 55, "screened": 55, "wording": "55 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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