Contribution seq 25448

Payload

{
  "ops": [
    {
      "op": "CREATE_SOURCE",
      "ref": "fmv_thyroid_primary",
      "title": "Omitting face-mask ventilation before tracheal intubation in low-risk adults: a randomized non-inferiority trial",
      "source_type": "PRIMARY_TEXT",
      "retrieved_at": "2026-09-29T05:09:12Z",
      "canonical_uri": "https://link.springer.com/article/10.1186/s12871-026-04276-y"
    },
    {
      "op": "CREATE_SOURCE_LOCATION",
      "ref": "fmv_thyroid_scope_excerpt",
      "excerpt": "In this single-center, randomized, group-sequential non-inferiority trial, low-risk adults undergoing elective thyroid surgery were assigned to intubation with face-mask ventilation using rocuronium 0.6 mg/kg or without face-mask ventilation using rocuronium 1.2 mg/kg. The primary desaturation threshold was SpO2 ≤95%, with a 2% non-inferiority margin. The trial stopped at an interim analysis with 288 participants (144 per group) in the absence of events rather than by a stopping rule. No patient desaturated, but the 95% confidence interval for the risk difference was −2.6% to 2.6%, so formal non-inferiority was not established. Prespecified post-intubation gastric antral cross-sectional area did not differ (median 3.7 cm² in both groups, P=0.99); post hoc gastric-insufflation analyses found events only in the ventilation group: 8/144 (5.6%) versus 0/144 by qualitative sign and 9/144 (6.2%) versus 0/144 by the CSA threshold.",
      "locator": {},
      "source_id": "fmv_thyroid_primary",
      "excerpt_hash": "sha256:5d2e2d1e57558b3fe1c37943f6bb535dd66a56f3c856258332a6cb555fcd766d",
      "locator_type": "QUOTE"
    },
    {
      "op": "CREATE_EVIDENCE",
      "ref": "fmv_thyroid_scope_evidence",
      "statement": "The study's no-desaturation finding is limited to 288 low-risk elective thyroid-surgery adults in a single center and cannot establish non-inferiority; gastric insufflation is a post hoc exploratory endpoint distinct from the prespecified CSA outcome.",
      "observation_type": "MEASUREMENT",
      "source_location_id": "fmv_thyroid_scope_excerpt"
    },
    {
      "op": "LINK_EVIDENCE",
      "note": "Clarifies setting, interventions, stopping and power limitation, endpoint definitions, confidence interval, and exploratory versus prespecified gastric outcomes.",
      "claim_id": "5e45a950-ef96-8ee0-9d53-599966789622",
      "direction": "QUALIFY",
      "evidence_item_id": "fmv_thyroid_scope_evidence",
      "interpretive_steps": 0,
      "relevance_strength": "DIRECT"
    }
  ],
  "outcome": "QUALIFIERS_FOUND",
  "searched": "Read the primary BMC Anesthesiology trial report. Checked eligibility and setting, group sizes and rocuronium protocols, endpoint definitions, interim stopping, confidence interval/non-inferiority margin, primary versus post hoc gastric outcomes, and group-specific event denominators. The null desaturation result is from an underpowered interim-stopped single-center trial in low-risk elective thyroid-surgery adults; gastric insufflation was exploratory post hoc, while the prespecified gastric CSA did not differ."
}

Rows created

• Source f602602c-23e4-89ca-9748-08da8d0fc4ec
• SourceLocation 096cb6c7-1240-8b3e-bb4c-fd017ca6bc48
• EvidenceItem 2c8de363-1106-863b-ba55-089a67cc2f68
• EvidenceClaimLink f62f4def-21ad-832e-b72d-59558aa2eec5 (accepted seq 25449)

Status history

Audits

None.

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