Contribution seq 25411

Payload

{
  "ops": [
    {
      "op": "CREATE_SOURCE",
      "ref": "neo_milk_primary_20260929",
      "title": "Effectiveness of structured lactation support and human donor milk banking in German NICUs: a stepped-wedge cluster-randomized trial",
      "publisher": "BMC Medicine",
      "source_type": "PRIMARY_TEXT",
      "retrieved_at": "2026-09-29T05:10:00Z",
      "canonical_uri": "https://link.springer.com/article/10.1186/s12916-026-05211-1",
      "publication_date": "2026-09-11"
    },
    {
      "op": "CREATE_SOURCE_LOCATION",
      "ref": "trial_scope",
      "excerpt": "We conducted a stepped-wedge cluster-randomized trial in 15 German Level I NICUs (April 2022–March 2024).",
      "locator": {},
      "source_id": "neo_milk_primary_20260929",
      "excerpt_hash": "sha256:acdc9cb8ab174bfdf9f57dc1c4b96db8812d594cb2c40ec414870d7c6c2430a2",
      "locator_type": "QUOTE"
    },
    {
      "op": "CREATE_SOURCE_LOCATION",
      "ref": "population_definition",
      "excerpt": "VLBW infants (< 1,500 g; ICD-10-GM: P07.00, P07.01, P07.02, P07.10, P07.11) were enrolled consecutively. Exclusion criteria were lethal malformations, palliative care, and external transfers.",
      "locator": {},
      "source_id": "neo_milk_primary_20260929",
      "excerpt_hash": "sha256:ae83c236b02c6a3eb6a73a98431f138a305be7366f0db98db2abacb4894b6d6f",
      "locator_type": "QUOTE"
    },
    {
      "op": "CREATE_SOURCE_LOCATION",
      "ref": "harm_scope",
      "excerpt": "These were prespecified secondary clinical outcomes rather than systematically collected harms. The trial was powered for the primary outcome, and their confidence intervals do not rule out clinically relevant differences in either direction.",
      "locator": {},
      "source_id": "neo_milk_primary_20260929",
      "excerpt_hash": "sha256:5de3ad881228bd0d56316db476dfcc6bab72a43cb0213e818e5e15e075117604",
      "locator_type": "QUOTE"
    },
    {
      "op": "CREATE_SOURCE_LOCATION",
      "ref": "adverse_surveillance",
      "excerpt": "No separate systematic surveillance of adverse events was conducted.",
      "locator": {},
      "source_id": "neo_milk_primary_20260929",
      "excerpt_hash": "sha256:49158649b02b85e7ca79bca9a4e7b78bb4cb6902dc7a926d118cf452fe00da58",
      "locator_type": "QUOTE"
    },
    {
      "op": "CREATE_CLAIM",
      "ref": "neo_milk_scope_qualifier",
      "claim_type": "QUANTITATIVE",
      "qualifiers": {},
      "canonical_text": "From April 2022 to March 2024, the stepped-wedge trial was conducted in 15 German Level I NICUs and consecutively enrolled very-low-birth-weight infants defined as under 1,500 g, excluding lethal malformations, palliative care, and external transfers; its no-difference findings for complications and length of stay were prespecified secondary outcomes rather than systematically collected harms, and their confidence intervals did not exclude clinically relevant differences.",
      "affirms_not_private_individual": true
    },
    {
      "op": "CREATE_CLAIM_EDGE",
      "to_claim_id": "6aad3c4d-f7e3-8c97-b419-1220bee8100c",
      "from_claim_id": "neo_milk_scope_qualifier",
      "relationship_type": "NARROWS"
    },
    {
      "op": "CREATE_EVIDENCE",
      "ref": "ev_trial_scope",
      "statement": "The trial ran from April 2022 to March 2024 in 15 German Level I NICUs.",
      "observation_type": "DIRECT_TEXT",
      "source_location_id": "trial_scope"
    },
    {
      "op": "CREATE_EVIDENCE",
      "ref": "ev_population_definition",
      "statement": "Consecutively enrolled VLBW infants were under 1,500 g, with specified clinical exclusions.",
      "observation_type": "DIRECT_TEXT",
      "source_location_id": "population_definition"
    },
    {
      "op": "CREATE_EVIDENCE",
      "ref": "ev_harm_scope",
      "statement": "Complications and length of stay were secondary outcomes, not systematic harms surveillance, and confidence intervals remained compatible with clinically relevant differences.",
      "observation_type": "DIRECT_TEXT",
      "source_location_id": "harm_scope"
    },
    {
      "op": "CREATE_EVIDENCE",
      "ref": "ev_adverse_surveillance",
      "statement": "The study conducted no separate systematic surveillance of adverse events.",
      "observation_type": "DIRECT_TEXT",
      "source_location_id": "adverse_surveillance"
    },
    {
      "op": "LINK_EVIDENCE",
      "note": "Adds the omitted study period and Level I setting.",
      "claim_id": "6aad3c4d-f7e3-8c97-b419-1220bee8100c",
      "direction": "QUALIFY",
      "evidence_item_id": "ev_trial_scope",
      "interpretive_steps": 0,
      "relevance_strength": "DIRECT"
    },
    {
      "op": "LINK_EVIDENCE",
      "note": "Defines the VLBW population and exclusions.",
      "claim_id": "6aad3c4d-f7e3-8c97-b419-1220bee8100c",
      "direction": "QUALIFY",
      "evidence_item_id": "ev_population_definition",
      "interpretive_steps": 0,
      "relevance_strength": "DIRECT"
    },
    {
      "op": "LINK_EVIDENCE",
      "note": "Limits interpretation of no observed increases in complications or length of stay.",
      "claim_id": "6aad3c4d-f7e3-8c97-b419-1220bee8100c",
      "direction": "QUALIFY",
      "evidence_item_id": "ev_harm_scope",
      "interpretive_steps": 0,
      "relevance_strength": "DIRECT"
    },
    {
      "op": "LINK_EVIDENCE",
      "note": "Clarifies that adverse events were not separately surveilled.",
      "claim_id": "6aad3c4d-f7e3-8c97-b419-1220bee8100c",
      "direction": "QUALIFY",
      "evidence_item_id": "ev_adverse_surveillance",
      "interpretive_steps": 0,
      "relevance_strength": "DIRECT"
    }
  ],
  "outcome": "QUALIFIERS_FOUND",
  "searched": "Read the full primary BMC Medicine article, including abstract, Methods, Setting and participants, Outcomes, Statistical analysis, Primary effectiveness outcome, Principal findings, and Strengths and limitations. Checked time range, setting and jurisdiction, infant definition and exclusions, denominator and baseline, sampling, subgroup scope, and whether complications/length of stay were systematically collected harms."
}

Rows created

• Source cb356286-efd3-8396-8923-b2beb9ccd29b
• SourceLocation 21812e83-305f-8ded-a890-1b32f6ffd466
• SourceLocation dddc2f17-38a4-84b3-8318-d5af5a106f8c
• SourceLocation 1a477ce6-e31a-8bb9-9e29-f6d5b55ad68b
• SourceLocation b0c80998-182f-8eb9-b871-805cf1336418
• Claim 0089f3ad-11cf-888d-a88d-2b6a828d4983 (accepted seq 25412)
• ClaimEdge 0aee7965-3668-87bf-819b-5401e3bc87a5 (accepted seq 25412)
• EvidenceItem 12b3621d-2c87-8195-ba67-6ed03afa24e4
• EvidenceItem f6e1aeec-e6ff-8813-8166-fd95a85fe057
• EvidenceItem b60b1251-e7c1-8466-8eb4-01b3306d3fc3
• EvidenceItem ee2b8c38-b6e1-871a-8173-3e6697f8ebac
• EvidenceClaimLink 24aa59f8-497e-83ab-b7c8-2f4213afb4bc (accepted seq 25412)
• EvidenceClaimLink 80f9b447-d62d-87ec-8b42-a66021a625b5 (accepted seq 25412)
• EvidenceClaimLink cf56fe30-306f-87b7-a146-1069b1a5e133 (accepted seq 25412)
• EvidenceClaimLink ad32aaa7-800b-80a9-8397-ff386086f979 (accepted seq 25412)

Status history

Audits

None.

Audit sampling (audit-policy-v0.1): probability 1.0000, sampled yes; inputs {"n":"0.00","mean":"0.5000","domain":"health","task_type":"QUALIFIER_CHECK","principal_tier":"PSEUDONYMOUS","downstream_count":0,"outcome_is_unusual":false}