[
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "The trial was double-blind and randomized.",
    "label": "supported"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "Dapagliflozin reduced heart failure hospitalization.",
    "label": "supported"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "Mean participant age was 66 years.",
    "label": "supported"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "Genital mycotic infections were more common with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "Dapagliflozin accelerated eGFR decline.",
    "label": "refuted"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "The study was open-label.",
    "label": "refuted"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "Diabetic ketoacidosis was more frequent with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "The trial was conducted in Europe and Asia.",
    "label": "refuted"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "Dapagliflozin reduced all-cause mortality.",
    "label": "not_supported"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "Retinopathy progression improved with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "Women derived greater benefit than men.",
    "label": "not_supported"
  },
  {
    "text": "The Willow CKD study was a double-blind, randomized trial of 1,120 adults with type 2 diabetes and albuminuric chronic kidney disease. Participants with baseline eGFR 30–60 mL/min/1.73 m2 were assigned to dapagliflozin 10 mg daily or matching placebo on top of ACE inhibitor or ARB therapy. The mean age was 66 years, 42% were women, and 18% identified as Black. The primary endpoint was the annual eGFR slope over 18 months; secondary outcomes included hospitalization for heart failure, change in albuminuria, and safety. Dapagliflozin slowed eGFR decline by 1.8 mL/min/1.73 m2 per year compared with placebo. It also reduced heart failure hospitalization by 27% relative to placebo. Hemoglobin A1c fell modestly by 0.3% without an increase in severe hypoglycemia. Genital mycotic infections occurred more often with dapagliflozin (7% vs 2%), while rates of diabetic ketoacidosis and amputations were similar between groups. Retinopathy and neuropathy outcomes were not systematically assessed, and all 42 centers were in the United States and Canada.",
    "subclaim": "Mean baseline systolic blood pressure was 140 mmHg.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "Antigen test results were available in about 15 minutes.",
    "label": "supported"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "Sensitivity was 78% compared with PCR.",
    "label": "supported"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "Rapid testing increased same-visit oseltamivir initiation.",
    "label": "supported"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "The assay does not detect SARS-CoV-2.",
    "label": "supported"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "Antibiotic prescribing increased after implementation.",
    "label": "refuted"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "The rapid test shortened ED length of stay.",
    "label": "refuted"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "Children under five were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "Specificity of the antigen test was below 70%.",
    "label": "refuted"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "The rapid test reduced hospital admission rates.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "Specificity for influenza B alone was 90%.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "Nasopharyngeal sampling outperformed nasal swabs.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study at three urban emergency departments evaluated a nurse-performed rapid antigen test for influenza A and B using nasal swabs against RT-PCR. Adults presenting with fever and cough during peak influenza season were enrolled, totaling 620 tested patients. The antigen test produced results in about 15 minutes, whereas PCR results were returned within eight hours. Compared with PCR, the antigen assay had 78% sensitivity and 96% specificity for influenza A/B combined. Implementation of the rapid test increased same-visit oseltamivir initiation from 18% to 41% among PCR-positive cases. Antibiotic prescribing rates did not change significantly. The intervention did not shorten emergency department length of stay. The assay does not detect SARS-CoV-2. No severe adverse events related to swabbing were reported.",
    "subclaim": "The test cost less than ten dollars per use.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "Empagliflozin slowed eGFR decline.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "Heart failure hospitalization was less frequent with empagliflozin.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "Genital mycotic infections were more common on empagliflozin.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "No diabetic ketoacidosis occurred in the trial.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "The trial included patients with type 1 diabetes.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "Empagliflozin increased hyperkalemia rates.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "Limb amputations were common in the empagliflozin arm.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "Empagliflozin accelerated kidney function loss.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "Empagliflozin improved diabetic retinopathy.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "Urinary tract infections decreased with empagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "Mean baseline eGFR was 45 mL/min/1.73 m2.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 512 adults with type 2 diabetes and stage 3 chronic kidney disease. Participants received empagliflozin 10 mg daily or placebo in addition to standard care, including ACE inhibitors, for 12 months. Empagliflozin slowed the rate of estimated GFR decline compared with placebo. Hospitalization for heart failure occurred less often in the empagliflozin group. Glycated hemoglobin decreased modestly by about 0.5% with empagliflozin. Rates of acute kidney injury and hyperkalemia were similar between groups. Genital mycotic infections were more frequent with empagliflozin. No cases of diabetic ketoacidosis or limb amputation were reported. Baseline mean age was 62 years, and type 1 diabetes was excluded.",
    "subclaim": "All participants used statins.",
    "label": "not_supported"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Tenecteplase 0.25 mg/kg replaced alteplase for eligible strokes.",
    "label": "supported"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Excellent 90-day functional outcome rates were similar between drugs.",
    "label": "supported"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Door-to-needle times were shorter with tenecteplase.",
    "label": "supported"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Early reperfusion before thrombectomy was more frequent after tenecteplase.",
    "label": "supported"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Tenecteplase required an infusion pump.",
    "label": "refuted"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Patients with recent DOAC use were included.",
    "label": "refuted"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Mortality at 90 days decreased after the switch.",
    "label": "refuted"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Symptomatic intracranial hemorrhage was higher with tenecteplase.",
    "label": "refuted"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Median age was 72 years.",
    "label": "not_supported"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Posterior circulation strokes were excluded.",
    "label": "not_supported"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Alteplase was dosed at 0.9 mg/kg.",
    "label": "not_supported"
  },
  {
    "text": "A regional stroke network switched from alteplase to tenecteplase 0.25 mg/kg for eligible ischemic stroke patients within 4.5 hours of onset. In a prospective registry of 684 adults (median NIHSS 9), outcomes with tenecteplase were compared to the prior year's alteplase cohort. Rates of excellent functional outcome at 90 days (mRS 0-1) were similar between drugs. Among large-vessel occlusion cases taken for thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase. Symptomatic intracranial hemorrhage rates did not differ. Door-to-needle time was shorter with tenecteplase because no infusion pump was required. All patients with recent direct oral anticoagulant use were excluded. Ninety-day mortality was unchanged after the switch. Intrahospital pneumonia occurred at similar frequency in both groups.",
    "subclaim": "Cognitive testing at 6 months was collected.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "A 0/1-hour hs-troponin T algorithm was used.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "48% were ruled out and discharged.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "18% of rule-in patients had MI during the index stay.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "ED length of stay decreased by about 2 hours.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "Implementation increased 30-day all-cause mortality.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "Women had a lower NPV than men.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "No myocardial infarctions occurred in the rule-in group.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "Patients with eGFR below 60 were excluded.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "Care costs decreased after implementation.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "Fewer outpatient stress tests were ordered post-implementation.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "Performance was worse on weekends.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with chest pain at two emergency departments. Among 1,240 consecutive patients, 48% met rule-out criteria and were discharged from the ED. In the rule-in group, 18% had myocardial infarction confirmed during the index admission. Thirty-day myocardial infarction or cardiac death occurred in 0.4% of those ruled out, yielding a negative predictive value of 99.6%. Median ED length of stay decreased by 2.1 hours after adoption of the algorithm. There was no significant difference in negative predictive value between women and men. Patients with reduced kidney function (eGFR <60 mL/min/1.73 m²) had more false negatives than those with preserved function (1.2% vs 0.2%). Overall 30-day all-cause mortality did not increase compared with the pre-implementation period (0.6% vs 0.7%). High-risk ECG changes still mandated admission regardless of troponin values.",
    "subclaim": "Rural hospitals participated in the study.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "Roxadustat produced a noninferior hemoglobin rise versus epoetin.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "LDL cholesterol decreased with roxadustat.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "Intravenous iron use was lower with roxadustat.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "Dialysis patients were excluded.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "Epoetin increased hemoglobin more than roxadustat.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "Roxadustat caused more hypertension than epoetin.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "Thromboembolic events were markedly higher with roxadustat.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "Active cancer patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "Roxadustat reduced all-cause mortality.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "Most participants had type 1 diabetes.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "Quality of life improved more with roxadustat.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with stage 3–4 chronic kidney disease and anemia (hemoglobin 8–11 g/dL) received roxadustat or epoetin alfa for 24 weeks. Roxadustat achieved noninferior hemoglobin improvement versus epoetin (mean +1.2 vs +1.1 g/dL). Rescue red-cell transfusions occurred in 4% on roxadustat and 6% on epoetin. Low-density lipoprotein cholesterol fell by a mean of 12 mg/dL with roxadustat. Hypertension was less frequent with roxadustat than with epoetin (7% vs 12%). Thromboembolic events were similar between groups (2.8% vs 3.1%). Intravenous iron use was lower with roxadustat (18% vs 27%), while oral iron and vitamin B12 were allowed in both arms. No difference was seen in eGFR slope over 24 weeks. Dialysis patients and those with active cancer were excluded from enrollment.",
    "subclaim": "The mean age exceeded 80 years.",
    "label": "not_supported"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "The trial lasted 48 weeks.",
    "label": "supported"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "Triple therapy reduced exacerbations versus dual therapy.",
    "label": "supported"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "Pneumonia was more frequent with triple therapy.",
    "label": "supported"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "Participants were 45–80 years old current or former smokers.",
    "label": "supported"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "Asthma patients were included.",
    "label": "refuted"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "FEV1 declined in the triple therapy arm.",
    "label": "refuted"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "All-cause mortality was lower with triple therapy.",
    "label": "refuted"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "The study compared triple therapy to placebo.",
    "label": "refuted"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "Most participants used home oxygen.",
    "label": "not_supported"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "Benefits were limited to eosinophils above 300 cells/µL.",
    "label": "not_supported"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "Most participants were Asian.",
    "label": "not_supported"
  },
  {
    "text": "A 48-week randomized trial enrolled adults aged 45–80 years with moderate-to-severe COPD who were current or former smokers. Participants were assigned to once-daily triple inhaler therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) or dual bronchodilator therapy (LABA/LAMA). The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy (rate ratio 0.78). Prebronchodilator FEV1 increased by a mean of 110 mL with triple therapy versus 35 mL with dual therapy. Pneumonia occurred in 4.0% of the triple group and 2.5% of the dual group. There was no between-group difference in all-cause mortality (1.2% vs 1.1%). Courses of oral corticosteroids for exacerbations were reduced by 18% with triple therapy. Patients with a history of asthma or recent myocardial infarction were excluded. Health-related quality of life improved modestly in both arms.",
    "subclaim": "Smoking cessation counseling was provided by the study.",
    "label": "not_supported"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "A 0/1-hour hs-troponin I algorithm was implemented.",
    "label": "supported"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "ST-elevation myocardial infarction patients were excluded.",
    "label": "supported"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "Emergency department length of stay decreased after implementation.",
    "label": "supported"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "Thirty-day MACE was similar between periods.",
    "label": "supported"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "This was a single-center study.",
    "label": "refuted"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "The implementation used a 0/3-hour protocol.",
    "label": "refuted"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "The mean age was 68 years.",
    "label": "refuted"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "Major bleeding increased after implementation.",
    "label": "refuted"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "Most patients arrived at night.",
    "label": "not_supported"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "Hospital costs decreased by 20%.",
    "label": "not_supported"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "Patients with chronic kidney disease were excluded.",
    "label": "not_supported"
  },
  {
    "text": "In eight emergency departments, a prospective before–after implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for adults with suspected non–ST-elevation acute coronary syndrome. Patients with ST-elevation myocardial infarction or hemodynamic instability were excluded. The post-implementation cohort (n=1,620) was compared with a usual-care cohort using a 0/3-hour approach (n=1,580). Median emergency department length of stay decreased from 6.2 to 4.4 hours after implementation. Direct discharge from the emergency department increased from 42% to 57%. Thirty-day major adverse cardiac events were similar between periods (4.3% vs 4.1%), meeting a prespecified noninferiority margin. Use of coronary CT angiography rose modestly (12% to 15%). No differences in major bleeding or all-cause mortality at 30 days were observed. The mean age was 58 years, and 46% of patients were women.",
    "subclaim": "All participating sites were rural hospitals.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "Dapagliflozin led to greater weight loss than glimepiride.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "Symptomatic hypoglycemia was less common with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "HbA1c reduction at 24 weeks was similar between groups.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "Genital mycotic infections were more frequent with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "The trial included patients with stage 4 chronic kidney disease.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "Diabetic ketoacidosis occurred in the dapagliflozin arm.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "Blood pressure increased with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "Cardiovascular events were significantly lower with dapagliflozin at 24 weeks.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "Mean baseline age was 68 years.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "The trial used a double-dummy design.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "Retinal outcomes were assessed.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes inadequately controlled on metformin were assigned to dapagliflozin 10 mg daily or glimepiride titrated up to 8 mg daily. The primary endpoint, change in HbA1c at 24 weeks, was similar between groups. Patients on dapagliflozin lost a mean of 2.4 kg, while those on glimepiride gained 0.7 kg. Symptomatic hypoglycemia occurred in 2% on dapagliflozin versus 15% on glimepiride. Office systolic blood pressure fell by about 3 mmHg with dapagliflozin and was unchanged with glimepiride. Estimated glomerular filtration rate remained stable in both arms, and participants with stage 4 chronic kidney disease were excluded. Genital mycotic infections were more frequent with dapagliflozin. No cases of diabetic ketoacidosis were observed in either group. Rates of adjudicated cardiovascular events did not differ significantly over 24 weeks.",
    "subclaim": "Asian patients comprised the majority.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "The 0/1-hour hs-cTnI algorithm reduced ED length of stay.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "Hospital admissions for chest pain decreased after implementation.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "Sensitivity for index myocardial infarction exceeded 99%.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "STEMI cases were excluded from the algorithm.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "The study was a randomized controlled trial.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "Thirty-day major adverse cardiac events increased after implementation.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "The algorithm was applied to pediatric patients.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "Fewer than 20% of patients were ruled out at one hour.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "Mean patient age was 58 years.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "The study was conducted at three hospitals.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "Emergency department costs decreased with the algorithm.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin I 0/1-hour algorithm combined with ECG for adults presenting with chest pain without ST-elevation. In a six-month before–after cohort including 1,200 visits, the pathway was evaluated. Within one hour, 45% of patients were ruled out and discharged or observed as low risk. Sensitivity for index myocardial infarction was 99.5% with a negative predictive value of 99.8%, and 30-day major adverse cardiac events were similar to the prior period. Median emergency department length of stay decreased by 1.8 hours, and hospital admissions for chest pain fell by 12%. Patients with moderate renal impairment had more indeterminate results but were not excluded from testing. There was no increase in 72-hour return visits for cardiac diagnoses. The algorithm was not applied to STEMI cases identified at triage.",
    "subclaim": "A cardiology consult was required before discharge.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "Azithromycin was 500 mg daily for 5 days.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "Amoxicillin-clavulanate was dosed twice daily for 7 days.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "Clinical stability by day 5 did not differ significantly.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "QT prolongation occurred only with azithromycin.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "ICU patients were included.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "Azithromycin had the longer planned duration.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "Procalcitonin was not used to guide antibiotics.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "QT prolongation occurred in both arms.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "Mean age was 72 years.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "The trial was conducted in Europe.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "Viral coinfection was present in 15%.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial at three urban hospitals enrolled 312 adults with community-acquired pneumonia not requiring intensive care. Participants received either azithromycin 500 mg daily for 5 days or amoxicillin-clavulanate 875/125 mg twice daily for 7 days. Antibiotics could be discontinued at 48 hours if procalcitonin was below 0.25 ng/mL and the patient was clinically stable. The primary outcome, clinical stability by day 5, was achieved in 72% with azithromycin and 68% with amoxicillin-clavulanate, a nonsignificant 4% difference. QT prolongation occurred in 3% of azithromycin recipients and in none of those on amoxicillin-clavulanate. Diarrhea occurred in 8% of azithromycin patients and 14% of amoxicillin-clavulanate patients. Median length of stay was slightly shorter with azithromycin (3.2 vs 3.5 days). Thirty-day mortality was 1.3% overall with no arm-specific difference, and transfers to intensive care were uncommon (4% vs 5%). Pathogen testing identified Streptococcus pneumoniae in 29% and atypical bacteria in 18% of cases.",
    "subclaim": "Outpatient parenteral antibiotics were used after discharge.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "Ferric carboxymaltose was given as two 750 mg infusions one week apart.",
    "label": "supported"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "Hemoglobin rose more with ferric carboxymaltose than ferrous sulfate.",
    "label": "supported"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "Symptomatic hypophosphatemia occurred only with ferric carboxymaltose.",
    "label": "supported"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "GI adverse effects were more common with ferrous sulfate.",
    "label": "supported"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "Only dialysis patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "Ferrous sulfate was dosed once daily.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "Hospitalizations were reduced with ferric carboxymaltose.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "Ferritin increased more with ferrous sulfate than IV iron.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "Mean baseline hemoglobin was 7.5 g/dL.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "Erythropoiesis-stimulating agents were used in 80%.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter trial of 228 adults with stage 3-4 chronic kidney disease and iron deficiency anemia, participants were randomized to intravenous ferric carboxymaltose or oral ferrous sulfate. Ferric carboxymaltose was administered as two 750 mg infusions one week apart; ferrous sulfate was dosed at 325 mg orally twice daily for 12 weeks. At week 8, mean hemoglobin increased by 1.8 g/dL with ferric carboxymaltose and 0.9 g/dL with ferrous sulfate. Transferrin saturation and ferritin rose more with the intravenous regimen. Symptomatic hypophosphatemia occurred in 6% of the ferric carboxymaltose group and in none of the oral iron group. Gastrointestinal adverse effects were more common with ferrous sulfate (nausea 22%, constipation 18%). No difference was seen in serious adverse events or hospitalizations through 12 weeks. Diabetic kidney disease was the most frequent etiology, present in 42% of participants.",
    "subclaim": "Intravenous fluids were co-administered during infusions.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "The trial compared tenecteplase with alteplase.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "CT perfusion mismatch was required for enrollment.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "Symptomatic intracranial hemorrhage was similar in both arms.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "Tenecteplase reduced door-to-needle time.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "The study enrolled pediatric stroke patients.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "Treatment was administered within 3 hours of onset.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "Alteplase achieved higher early reperfusion than tenecteplase.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "Recent direct oral anticoagulant use was permitted.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "Ninety-day mortality was lower with tenecteplase.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "The tenecteplase dose was 0.25 mg/kg.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "Thrombolysis was followed by mandated thrombectomy.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated tenecteplase versus alteplase for adults with acute ischemic stroke presenting 4.5 to 9 hours after last known well. Patients were selected using CT perfusion to demonstrate a penumbra–core mismatch. Six hundred twelve participants were randomized in a 1:1 ratio with blinded outcome assessment. The primary endpoint was functional independence at 90 days, with early reperfusion at 24 hours as a key secondary outcome. Tenecteplase was noninferior to alteplase for the primary endpoint and achieved higher early reperfusion. Symptomatic intracranial hemorrhage rates were similar between groups. Median door-to-needle time was 7 minutes shorter with tenecteplase. A prespecified subgroup with large-vessel occlusion had greater reperfusion with tenecteplase. Patients with recent use of direct oral anticoagulants within 48 hours were excluded from enrollment.",
    "subclaim": "Patients older than 90 years were excluded.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "Adults with uncomplicated gram-negative bacteremia were randomized to 7 vs 14 days.",
    "label": "supported"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "The primary endpoint was a 90-day composite including mortality and relapse.",
    "label": "supported"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "Seven days was noninferior to 14 days.",
    "label": "supported"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "Endocarditis cases were excluded.",
    "label": "supported"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "Most infections were from skin and soft tissue sources.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "Only Pseudomonas infections were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "The 7-day arm had higher C. difficile rates.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "Severely immunocompromised patients were included.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "Most patients stepped down to oral therapy by day 2.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "Beta-lactams outperformed fluoroquinolones.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "Thirty-day recurrence was lower with 14 days.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic noninferiority trial across 24 hospitals compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bloodstream infection stabilized by day 3. Most infections originated from the urinary tract, and organisms were predominantly Enterobacterales. Severely immunocompromised patients, endocarditis, retained intravascular devices, and osteomyelitis were excluded. Participants were randomized after source control, and infectious diseases consultation was used in most cases. The primary outcome was a 90-day composite of all-cause mortality, relapse, suppurative complications, or readmission. Seven days was noninferior to 14 days for this composite. Antibiotic-related adverse events were fewer and intravenous therapy duration shorter in the 7-day arm. Rates of Clostridioides difficile infection did not differ between groups.",
    "subclaim": "Outpatient parenteral therapy was mandatory.",
    "label": "not_supported"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "Adults aged 55–80 with COPD were enrolled.",
    "label": "supported"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "Triple therapy reduced exacerbations by about 22%.",
    "label": "supported"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "Dry mouth was more frequent with triple therapy.",
    "label": "supported"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "The eosinophil-high subgroup had greater benefit.",
    "label": "supported"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "Patients with a history of asthma were included.",
    "label": "refuted"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "Triple therapy prolonged the QT interval.",
    "label": "refuted"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "Mortality was lower with triple therapy.",
    "label": "refuted"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "Dual therapy improved FEV1 more than triple therapy.",
    "label": "refuted"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "Most participants were women.",
    "label": "not_supported"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "The study was conducted in Canada.",
    "label": "not_supported"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "Smoking cessation counseling was provided.",
    "label": "not_supported"
  },
  {
    "text": "An open-label randomized trial enrolled 462 adults aged 55–80 with COPD and at least two exacerbations in the prior year. Participants were current or former smokers without a history of asthma. They were assigned to inhaled triple therapy with budesonide-formoterol-glycopyrronium or to budesonide-formoterol alone for 24 weeks. The primary outcome was the annualized rate of moderate-to-severe exacerbations, which was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL in the triple therapy group versus 20 mL with dual therapy. Rates of pneumonia and all-cause mortality did not differ between groups. Dry mouth and urinary retention were more frequent on triple therapy, while QT intervals were unchanged on serial ECGs. A prespecified subgroup with blood eosinophils >=300 cells/uL showed a larger reduction in exacerbations. Medication adherence and rescue inhaler use were similar across arms.",
    "subclaim": "Triple therapy reduced hospital length of stay.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "Seven hundred eighty patients were randomized.",
    "label": "supported"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "The procalcitonin protocol reduced antibiotic duration.",
    "label": "supported"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "28-day mortality was similar between groups.",
    "label": "supported"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "C. difficile infection was less frequent with the protocol.",
    "label": "supported"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "The protocol required procalcitonin above 1.0 mcg/L to stop antibiotics.",
    "label": "refuted"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "ICU length of stay was longer with the protocol.",
    "label": "refuted"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "The study enrolled only outpatients.",
    "label": "refuted"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "Acute kidney injury was significantly lower with the protocol.",
    "label": "refuted"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "Median age was 72 years.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "Most patients had pneumonia.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "Procalcitonin was measured every 12 hours.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter pragmatic trial evaluated procalcitonin-guided discontinuation of antibiotics in adults admitted to hospital with suspected sepsis. Seven hundred eighty patients were randomized to a procalcitonin protocol or to usual care. The protocol advised stopping antibiotics when procalcitonin fell by at least 80% from peak or dropped below 0.5 mcg/L. Median antibiotic duration was 6.0 days with the protocol versus 8.5 days with usual care. 28-day mortality did not differ between groups. ICU length of stay was similar. Clostridioides difficile infection occurred less often with the protocol (1.7% vs 4.2%). Rates of acute kidney injury were comparable. Time to antimicrobial de-escalation was shorter by about one day in the protocol arm.",
    "subclaim": "The trial took place in Asia.",
    "label": "not_supported"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "Semaglutide lowered HbA1c more than glargine at 24 weeks.",
    "label": "supported"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "Weight fell with semaglutide and rose with glargine.",
    "label": "supported"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "Hypoglycemia was less common with semaglutide.",
    "label": "supported"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "Pregnant individuals were excluded.",
    "label": "supported"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "Patients with eGFR below 30 mL/min/1.73 m2 were eligible.",
    "label": "refuted"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "Gastrointestinal events were rarer with semaglutide than with glargine.",
    "label": "refuted"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "The primary endpoint was hospitalization for heart failure.",
    "label": "refuted"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "The study enrolled adolescents.",
    "label": "refuted"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "More patients on semaglutide achieved HbA1c under 7%.",
    "label": "not_supported"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "Continuous glucose monitoring guided insulin titration.",
    "label": "not_supported"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "Semaglutide reduced major adverse cardiovascular events.",
    "label": "not_supported"
  },
  {
    "text": "An eight-center randomized trial evaluated once-weekly semaglutide versus daily insulin glargine in adults aged 40–75 years with type 2 diabetes inadequately controlled on metformin. The primary outcome was change in HbA1c at 24 weeks. Mean HbA1c fell by 1.4% with semaglutide and 1.0% with glargine (p=0.02). Body weight decreased by 3.8 kg with semaglutide but increased by 0.9 kg with glargine. Confirmed symptomatic hypoglycemia occurred in 4% of semaglutide-treated patients and 12% of those on glargine. Nausea and other gastrointestinal events were more frequent with semaglutide (18% vs 6%). Participants with estimated GFR below 45 mL/min/1.73 m2 and pregnant individuals were excluded; background metformin was continued. Kidney function and diabetic retinopathy findings were stable over the 24-week period.",
    "subclaim": "Diabetic neuropathy symptoms improved with semaglutide.",
    "label": "not_supported"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "Early start meant DOAC initiation within 3 days.",
    "label": "supported"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "Patients with NIHSS scores above 20 were excluded.",
    "label": "supported"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "Recurrent ischemic stroke at 30 days was lower with early initiation.",
    "label": "supported"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "Major bleeding at 30 days was similar between groups.",
    "label": "supported"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "This was a randomized controlled trial.",
    "label": "refuted"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "Heparin bridging was routinely used.",
    "label": "refuted"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "Patients with primary intracerebral hemorrhage were included.",
    "label": "refuted"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "The median age was under 40 years.",
    "label": "refuted"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "Warfarin outperformed DOACs in preventing stroke.",
    "label": "not_supported"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "Mechanical thrombectomy was more common in the early group.",
    "label": "not_supported"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "Diabetes modified the benefit of early initiation.",
    "label": "not_supported"
  },
  {
    "text": "Investigators conducted a prospective multicenter cohort of patients with acute ischemic stroke attributed to atrial fibrillation, comparing early versus delayed initiation of direct oral anticoagulants. Early start was defined as initiation within 3 days of symptom onset, while delayed start occurred between days 4 and 14. Patients with primary intracerebral hemorrhage, large territorial infarction, or NIHSS scores above 20 were excluded. The median age was 74 years, and 46% were women. Recurrent ischemic stroke by 30 days occurred in 3.1% of the early group compared with 6.2% of the delayed group. Rates of major bleeding at 30 days were similar between groups (1.4% vs 1.6%). No heparin bridging was used, and therapy selection favored apixaban or dabigatran per local formulary. Brain MRI was recommended before anticoagulation to screen for hemorrhagic transformation. Ninety-day functional outcomes and mortality were recorded, but no cost-effectiveness analysis was performed.",
    "subclaim": "One-year mortality was lower with early initiation.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "SMART reduced severe exacerbations versus fluticasone–salmeterol.",
    "label": "supported"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "Rescue albuterol use was lower with SMART.",
    "label": "supported"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "FEV1 change was not significantly different between groups.",
    "label": "supported"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "Active smokers were excluded.",
    "label": "supported"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "All participants were adults.",
    "label": "refuted"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "Hospitalizations were lower with SMART.",
    "label": "refuted"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "Tremor was more frequent with SMART.",
    "label": "refuted"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "Follow-up lasted 52 weeks.",
    "label": "refuted"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "Cost-effectiveness was evaluated.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "Eosinophil counts guided randomization.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "Electronic inhaler monitors assessed adherence.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, open-label trial enrolled 312 adolescents aged 12–17 years with moderate persistent asthma. Participants were assigned to budesonide–formoterol 160/4.5 µg two inhalations twice daily used for both maintenance and relief (SMART) or fluticasone–salmeterol 250/50 µg one inhalation twice daily with albuterol as needed. Follow-up lasted 24 weeks. The rate of severe exacerbations requiring oral corticosteroids was lower with SMART (rate ratio 0.68, 95% CI 0.52–0.90). Mean pre-bronchodilator FEV1 improved in both groups with no significant between-group difference. Cumulative oral steroid bursts were fewer in the SMART group. Rescue albuterol use was lower with SMART. Growth velocity over 24 weeks did not differ between groups. Tremor was reported more often in the fluticasone–salmeterol group; serious adverse events and hospitalizations were similar. Active smokers were excluded, and 48% of participants were female.",
    "subclaim": "The trial was conducted only in North America.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "1,050 adults were studied.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "Disposition time decreased after implementation.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "Sensitivity for index myocardial infarction was about 99%.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "Thirty-day myocardial infarction or death did not increase.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "Specificity exceeded 90%.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "Pediatric patients were included.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "The algorithm increased mortality.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "D-dimer testing was part of the protocol.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "Unit cost per patient decreased.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "Sex-specific troponin cutoffs were used.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "Two hospitals participated.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin T 0/1-hour algorithm for adults presenting with chest pain. In a before–after cohort of 1,050 adults (510 before, 540 after), median time from arrival to disposition fell from 8.1 hours to 4.3 hours post-implementation. Sensitivity for index myocardial infarction was 99.2%, with specificity of 64.1%. Thirty-day myocardial infarction or death among rule-out patients was 0.3% and did not increase compared with the pre-implementation period. No pediatric patients were enrolled. Renal impairment was present in 15% of participants, and the negative predictive value remained above 99.5%. Early discharges increased without a rise in return visits for ischemia. The protocol did not include D-dimer testing.",
    "subclaim": "Current smoking status modified accuracy.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "The trial compared immediate amoxicillin-clavulanate with watchful waiting.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "At 48 hours, more children in the antibiotic group had no ear pain.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "Diarrhea was more frequent with antibiotics.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "No mastoiditis occurred during follow-up.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "Children under 1 year were included.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "Tympanic membrane perforation occurred only in the control group.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "The benefit of antibiotics disappeared by 48 hours.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "Less than half of antibiotic recipients adhered to therapy.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "Ear pain was measured with a 10-point visual analog scale.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "Children with penicillin allergy were excluded.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in 18 primary care clinics enrolled children aged 2–6 years with uncomplicated acute otitis media. Participants were randomized to immediate 7-day amoxicillin-clavulanate or watchful waiting with rescue antibiotics if pain persisted. At 48 hours, 62% of the antibiotic group reported no ear pain versus 45% with watchful waiting. By day 7, symptom resolution exceeded 85% in both groups, and between-group differences were small. Diarrhea occurred in 14% of antibiotic recipients and 5% of controls. Tympanic membrane perforation was rare (about 1% in each arm). No cases of mastoiditis were observed during 14-day follow-up. Effects were similar in children attending daycare and those cared for at home. Exclusion criteria included prior antibiotic use in the past week and chronic suppurative otitis media. Adherence to the 7-day regimen exceeded 90% as measured by bottle weight.",
    "subclaim": "Antibiotics reduced school absenteeism.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "Dapagliflozin slowed eGFR decline versus placebo.",
    "label": "supported"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "Hospitalizations for heart failure were reduced with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "Genital mycotic infections were more common with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "Patients with type 1 diabetes were excluded.",
    "label": "supported"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "The trial enrolled dialysis patients.",
    "label": "refuted"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "Dapagliflozin caused more hyperkalemia than placebo.",
    "label": "refuted"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "Retinopathy improved with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "Diabetic ketoacidosis was frequent in the dapagliflozin arm.",
    "label": "refuted"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "The mean baseline eGFR was 42 mL/min/1.73 m2.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "The primary endpoint included albuminuria change.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "Metformin use was required at baseline.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, placebo-controlled trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease already treated with an ACE inhibitor or ARB. Participants received dapagliflozin 10 mg daily or matching placebo for 12 months. Dapagliflozin slowed the eGFR decline compared with placebo, after a small early dip in the first two weeks. Hospitalizations for heart failure were less frequent with dapagliflozin. Office systolic blood pressure decreased by about 3 mmHg in the active arm. Genital mycotic infections were more common with dapagliflozin, but diabetic ketoacidosis was rare in both groups. Rates of hyperkalemia and acute kidney injury did not differ meaningfully between arms. There was no signal for retinopathy worsening or improvement over the study period. Patients with type 1 diabetes or on dialysis were excluded from enrollment.",
    "subclaim": "Adherence exceeded 95%.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "ICU patients were excluded.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "Clinical cure at day 14 was noninferior between arms.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "Diarrhea was more frequent with amoxicillin-clavulanate.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "Median hospital stay was 3 days in both groups.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "Patients were managed in intensive care units.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "Azithromycin had higher mortality than amoxicillin-clavulanate.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "Atypical pathogens were absent.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "QT prolongation was frequent with azithromycin.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "Mean participant age was 68 years.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "The trial was conducted in Asia.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "Procalcitonin guided antibiotic duration.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated, multicenter randomized trial enrolled adults with mild-to-moderate community-acquired pneumonia treated on general wards. Patients requiring intensive care or vasopressors were excluded. Participants were assigned to 5 days of oral azithromycin (500 mg day 1, then 250 mg daily) or 7 days of oral amoxicillin-clavulanate (875/125 mg twice daily). The primary endpoint was clinical cure at day 14, which occurred in 82% with azithromycin and 80% with amoxicillin-clavulanate, meeting noninferiority. Thirty-day mortality was 1% in each group. Diarrhea was more common with amoxicillin-clavulanate, while nausea was infrequent and similar across arms. Streptococcus pneumoniae accounted for 40% of identified pathogens, Haemophilus influenzae for 25%, and atypical organisms for 15%; macrolide resistance among pneumococci was 10%. Median hospital length of stay was 3 days in both groups. QT interval prolongation was rare and no arrhythmias were observed.",
    "subclaim": "Hepatotoxicity led to many discontinuations.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "Pregnant patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "CTPA use decreased from 46% to 32%.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "Three-month VTE after a negative no-imaging workup was 0.4%.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "Patients with active cancer were included.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "The strategy increased PE-related mortality.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "PE prevalence among scanned patients exceeded 30%.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "Sensitivity dropped below 90%.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "Hemodynamically unstable patients were eligible.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "The median age was 76 years.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "A point-of-care D-dimer assay was used.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "Baseline outpatient anticoagulant use was 20%.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study in an emergency department evaluated an age-adjusted D-dimer strategy for suspected pulmonary embolism. Adults with hemodynamic stability were eligible; pregnancy was an exclusion. Clinicians used a simplified Wells score to stratify pretest probability and applied an age-adjusted D-dimer threshold (age × 10 ng/mL) to rule out PE without imaging in low or intermediate probability patients. After implementation, the rate of CT pulmonary angiography fell from 46% to 32% without an increase in missed PE. The 3-month rate of symptomatic venous thromboembolism after a negative, no-imaging workup was 0.4%, and there were no PE-related deaths. The overall sensitivity of the strategy was 98.5% with improved specificity compared to a fixed 500 ng/mL cutoff. Among those who underwent imaging, the prevalence of PE was 12%. Patients with active cancer were included and analyzed as a prespecified subgroup. Fewer cases of contrast-associated kidney injury were observed, consistent with fewer scans.",
    "subclaim": "Average radiation dose per CTPA was 6 mSv.",
    "label": "not_supported"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "Clinical cure met noninferiority at day 14.",
    "label": "supported"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "Median hospital stay was 3 days in both arms.",
    "label": "supported"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "Diarrhea was more common with amoxicillin–clavulanate.",
    "label": "supported"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "Tendon symptoms occurred only with levofloxacin.",
    "label": "supported"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "Pregnant patients were included.",
    "label": "refuted"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "Levofloxacin reduced 30-day mortality.",
    "label": "refuted"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "QT prolongation events occurred in the azithromycin arm.",
    "label": "refuted"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "The amoxicillin–clavulanate course lasted 10 days.",
    "label": "refuted"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "Streptococcus pneumoniae was the most common pathogen.",
    "label": "not_supported"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "Clostridioides difficile infection was more frequent with levofloxacin.",
    "label": "not_supported"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "ICU admissions were higher in the levofloxacin arm.",
    "label": "not_supported"
  },
  {
    "text": "This multicenter pragmatic trial enrolled 624 adults aged 65 years or older presenting to emergency departments with community-acquired pneumonia. Participants were randomized to 5 days of high-dose amoxicillin–clavulanate plus 3 days of azithromycin, or to 7 days of levofloxacin 750 mg daily. Clinical cure at day 14 was similar between groups (83% vs 81%), meeting the prespecified noninferiority margin. Median hospital stay was 3 days in both arms. Diarrhea occurred more often with amoxicillin–clavulanate (16% vs 9%), while tendon-related symptoms were reported only with levofloxacin (3 patients). Thirty-day mortality was 2% in each group, and 30-day readmission did not differ (10% vs 11%). Patients with eGFR below 30 mL/min/1.73 m2, pregnancy, or recent hospitalization were excluded. No cases of QT prolongation or torsades de pointes were recorded.",
    "subclaim": "Discharge on home oxygen was less common with amoxicillin–clavulanate.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Participants had LVEF ≥50%.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Empagliflozin lowered first heart failure hospitalization.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Diabetes was not required for enrollment.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Genital mycotic infections were more frequent with empagliflozin.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Participants were required to have LVEF below 40%.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Empagliflozin caused more severe hypoglycemia than placebo.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Diabetic ketoacidosis occurred with empagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Systolic blood pressure was unchanged in the empagliflozin arm.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "The average participant age exceeded 80 years.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Six-minute walk distance improved more with empagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Loop diuretic doses were reduced more with empagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial evaluated empagliflozin 10 mg daily versus placebo in 1,980 adults with heart failure with preserved ejection fraction (LVEF ≥50%). Participants had NYHA class II–III symptoms and eGFR ≥30 mL/min/1.73 m2; diabetes was not required. Over a median 14 months, empagliflozin reduced the composite of cardiovascular death or heart failure hospitalization (12.8% vs 16.5%). The rate of first heart failure hospitalization was lower with empagliflozin (8.1% vs 11.4%). Mean KCCQ clinical summary score improved by 4.2 points at 6 months with empagliflozin versus 1.9 with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active arm. Genital mycotic infections occurred more often with empagliflozin (3.6% vs 0.9%), while diabetic ketoacidosis was not observed. Incidence of severe hypoglycemia was similar between groups.",
    "subclaim": "Empagliflozin slowed eGFR decline.",
    "label": "not_supported"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "The study was open-label",
    "label": "supported"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "PASI75 was higher with the biologic than methotrexate",
    "label": "supported"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "Injection-site reactions were more frequent on the biologic",
    "label": "supported"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "No cancers were reported during follow-up",
    "label": "supported"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "The trial was double-blind",
    "label": "refuted"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "Pediatric patients were enrolled",
    "label": "refuted"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "Severe ALT elevations were more frequent on the biologic",
    "label": "refuted"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "Serious adverse events were attributed to study drugs",
    "label": "refuted"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "Baseline PASI scores were balanced",
    "label": "not_supported"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "The biologic improved nail psoriasis severity",
    "label": "not_supported"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "Biologic dosing was weight-based",
    "label": "not_supported"
  },
  {
    "text": "Adults with moderate-to-severe plaque psoriasis were randomized to an IL-17A inhibitor given every 4 weeks or oral methotrexate once weekly. The open-label study enrolled 412 patients and followed them for 24 weeks. At week 16, PASI75 was achieved in 78% with the biologic versus 42% with methotrexate. Mean Dermatology Life Quality Index scores improved more with the biologic at all visits. Injection-site reactions occurred in 9% on the biologic and 1% on methotrexate. ALT elevations above three times the upper limit occurred in 12% on methotrexate and 1% on the biologic. No malignancies were observed in either arm during follow-up. The trial excluded patients with active psoriatic arthritis and severe hepatic disease. Two serious adverse events occurred in the methotrexate group and one in the biologic group, none judged related to treatment.",
    "subclaim": "The trial was industry-sponsored",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "The pathway used a hs-troponin 0/1-hour algorithm plus HEART score",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "Thirty-eight percent were discharged without stress testing",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "Thirty-day MACE was 0.4% among discharged patients",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "Admission rates declined after implementation",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "ST-elevation MI patients were included",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "Return visits within 72 hours increased",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "Length of stay increased by about two hours",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "Stress testing was required before discharge",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "Patients were followed for one year",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "Sex-specific troponin cutoffs were used",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "Coronary CT angiography was part of the protocol",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm combined with a HEART score to evaluate adults with chest pain. Patients with ST-elevation on ECG or hemodynamic instability were excluded from the pathway. Among 1,204 consecutive patients, 38% were ruled out and discharged without stress testing. The sensitivity for index myocardial infarction was 99.5%, with a negative predictive value of 99.8%. Thirty-day major adverse cardiac events occurred in 0.4% of those discharged by the pathway. Compared with the prior protocol, mean length of stay decreased by 2.1 hours. The hospital admission rate declined from 41% to 28% after implementation. There was no increase in return emergency visits within 72 hours. The pathway was applied during daytime and overnight hours without protocol changes.",
    "subclaim": "The median HEART score was 2",
    "label": "not_supported"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "240 adults with CAP were randomized.",
    "label": "supported"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "The 5-day regimen was noninferior for day-14 cure.",
    "label": "supported"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "Diarrhea was less common with 5 days.",
    "label": "supported"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "C. difficile occurred only in the 7-day arm.",
    "label": "supported"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "Azithromycin was compared with levofloxacin.",
    "label": "refuted"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "Mortality was higher with 5 days.",
    "label": "refuted"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "Hospital stay was longer with 5 days.",
    "label": "refuted"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "Patients 65+ had worse outcomes with 5 days.",
    "label": "refuted"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "30-day readmission was lower with 5 days.",
    "label": "not_supported"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "Radiographic resolution was faster with 5 days.",
    "label": "not_supported"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "Penicillin-allergic patients were included.",
    "label": "not_supported"
  },
  {
    "text": "At three hospitals, a randomized open-label trial enrolled 240 adults with mild to moderate community-acquired pneumonia without immunosuppression. Participants were assigned 1:1 to high-dose amoxicillin-clavulanate for 5 days or the same regimen for 7 days. The primary outcome was clinical cure at day 14, which occurred in 82% of the 5-day group and 80% of the 7-day group, meeting a noninferiority margin of -10%. Median time to defervescence did not differ between groups. Antibiotic-associated diarrhea was less frequent with 5 days (9%) than 7 days (17%). Two cases of Clostridioides difficile infection occurred in the 7-day arm and none in the 5-day arm. Length of hospital stay was similar across groups, and all-cause mortality was rare and comparable (one death per arm). Outcomes among patients aged 65 years or older did not differ from younger adults, with no evidence of treatment interaction. Patients with severe sepsis were excluded.",
    "subclaim": "Short-course therapy reduced resistance rates.",
    "label": "not_supported"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "1,200 adults were enrolled.",
    "label": "supported"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "Patients with eGFR <30 mL/min/1.73 m2 were excluded.",
    "label": "supported"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "Rule-out NPV was 99.5%.",
    "label": "supported"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "ED length of stay was reduced versus the 0/3-hour approach.",
    "label": "supported"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "The study used conventional troponin T.",
    "label": "refuted"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "Rule-in PPV exceeded 90%.",
    "label": "refuted"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "Missed MI increased.",
    "label": "refuted"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "Performance was worse in women.",
    "label": "refuted"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "Direct ED discharge rates increased.",
    "label": "not_supported"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "Per-patient costs decreased.",
    "label": "not_supported"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "Use of the HEART score was mandated.",
    "label": "not_supported"
  },
  {
    "text": "At two urban emergency departments, a prospective cohort of 1,200 adults with chest pain underwent a 0/1-hour high-sensitivity cardiac troponin I algorithm using a single Siemens assay. The primary endpoint was myocardial infarction or cardiac death within 30 days. The algorithm classified 52% of patients as rule-out with a negative predictive value of 99.5% and sensitivity of 98.8% for the primary endpoint. Among rule-in patients (17%), the positive predictive value was 68%. Compared with a matched historical 0/3-hour strategy, median emergency department length of stay was 1.4 hours shorter. There was no increase in missed myocardial infarctions during follow-up. Test performance did not differ by sex, and patients with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. Three deaths occurred from noncardiac causes.",
    "subclaim": "Downstream stress testing decreased.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "Adults hospitalized with community-acquired pneumonia were enrolled.",
    "label": "supported"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "Participants were randomized 1:1 to procalcitonin guidance or usual care.",
    "label": "supported"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "Antibiotic duration was shorter with procalcitonin guidance.",
    "label": "supported"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "Severe immunosuppression was an exclusion criterion.",
    "label": "supported"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "The trial included pediatric patients.",
    "label": "refuted"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "Antibiotic duration was longer in the procalcitonin arm.",
    "label": "refuted"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "ICU transfers were more frequent with procalcitonin guidance.",
    "label": "refuted"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "All patients received azithromycin at admission.",
    "label": "refuted"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "Baseline procalcitonin levels exceeded 10 ng/mL.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "Hospital length of stay was reduced by procalcitonin guidance.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "The trial was conducted across five countries.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, controlled trial enrolled 240 adults hospitalized with community-acquired pneumonia confirmed by chest radiograph. Participants were randomized 1:1 to procalcitonin-guided antibiotic discontinuation or usual care. The procalcitonin protocol recommended stopping antibiotics when levels fell below 0.25 ng/mL or declined by 80% from baseline. Median antibiotic duration was 4 days in the procalcitonin arm versus 7 days with usual care. Thirty-day mortality was similar (3% vs 4%), and ICU transfers were identical (9% vs 9%). Clostridioides difficile infection occurred less often with procalcitonin guidance (1 vs 5 cases). Regimens at admission, including beta-lactams and macrolides, were balanced between groups. Only 39% received azithromycin at admission. Patients with severe immunosuppression were excluded, and the mean age was 64 years.",
    "subclaim": "Penicillin allergy predicted longer antibiotic courses.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "A point-of-care multiplex PCR for influenza and RSV was evaluated.",
    "label": "supported"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "Influenza A sensitivity was 92%.",
    "label": "supported"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "Median turnaround time was 35 minutes.",
    "label": "supported"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "Antibiotic prescribing decreased with device use.",
    "label": "supported"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "Chest radiography was the reference standard.",
    "label": "refuted"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "RSV sensitivity exceeded 95%.",
    "label": "refuted"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "Seven-day return visits increased with the device.",
    "label": "refuted"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "There were no invalid test runs.",
    "label": "refuted"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "SARS-CoV-2 detection was assessed.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "All participants were inpatients.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "Influenza B specificity was below 80%.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective evaluation at three emergency departments, we assessed a point-of-care multiplex PCR for influenza A/B and RSV in 600 outpatients with acute respiratory illness. The device was compared against the hospital laboratory RT-PCR as the reference standard. Sensitivity and specificity for influenza A were 92% and 98%, respectively. RSV sensitivity was 88% with 99% specificity. Median turnaround time for the point-of-care result was 35 minutes versus 8 hours for standard testing. Among tested patients, antibiotic prescribing at discharge decreased from 28% historically to 18% during device use. Return visits within 7 days were unchanged (7% with the device vs 7% with standard testing). Invalid runs occurred in 3% and were repeated on a backup cartridge. The cost per consumable was approximately $45.",
    "subclaim": "The study was randomized.",
    "label": "not_supported"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Tenecteplase shortened door-to-needle time versus alteplase.",
    "label": "supported"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Early reperfusion before thrombectomy was more frequent with tenecteplase.",
    "label": "supported"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Symptomatic intracranial hemorrhage rates were similar between groups.",
    "label": "supported"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Patients on therapeutic anticoagulation were excluded.",
    "label": "supported"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Ninety-day mortality was lower with tenecteplase.",
    "label": "refuted"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Perfusion imaging was mandatory for enrollment.",
    "label": "refuted"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "The trial enrolled only posterior circulation strokes.",
    "label": "refuted"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Alteplase had faster door-to-needle times than tenecteplase.",
    "label": "refuted"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Baseline NIHSS median was 14.",
    "label": "not_supported"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Treating clinicians were blinded to assignment.",
    "label": "not_supported"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Diabetes modified the treatment effect.",
    "label": "not_supported"
  },
  {
    "text": "Adults with suspected anterior circulation ischemic stroke within 4.5 hours were treated in a pragmatic trial at seven hospitals. Patients were randomized to tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg before thrombectomy when indicated. Median door-to-needle time was 32 minutes with tenecteplase and 41 minutes with alteplase. Early reperfusion before the first thrombectomy pass occurred in 28% with tenecteplase versus 16% with alteplase. Rates of symptomatic intracranial hemorrhage were similar (3.2% vs 3.5%). Ninety-day mortality did not differ, but more patients on tenecteplase achieved modified Rankin Scale 0–2. Outcomes in patients over 80 years mirrored the overall effect. Patients on therapeutic anticoagulation were excluded, and perfusion imaging was not required.",
    "subclaim": "Over 90% of participants underwent thrombectomy.",
    "label": "not_supported"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Procalcitonin guidance reduced total antibiotic days.",
    "label": "supported"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Thirty-day mortality was similar between groups.",
    "label": "supported"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Severely immunosuppressed patients were excluded.",
    "label": "supported"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Time to first antibiotic dose was unchanged by the protocol.",
    "label": "supported"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Antibiotics were recommended when procalcitonin was below 0.1 micrograms per liter.",
    "label": "refuted"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "ICU admissions were lower with procalcitonin guidance.",
    "label": "refuted"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Clinical cure was higher in the procalcitonin group.",
    "label": "refuted"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Seven-day return ED visits were fewer with procalcitonin.",
    "label": "refuted"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Median age was 65 years.",
    "label": "not_supported"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Macrolides were the most commonly used antibiotics.",
    "label": "not_supported"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Radiographic confirmation of pneumonia was required.",
    "label": "not_supported"
  },
  {
    "text": "In a large urban emergency department network, adults with suspected community-acquired pneumonia were assigned to a procalcitonin-guided protocol or usual care. In the protocol, antibiotics were discouraged when procalcitonin was below 0.1 micrograms per liter and encouraged above 0.25 micrograms per liter. The procalcitonin group had a median of five antibiotic days versus seven with usual care. Thirty-day mortality and ICU admissions were similar between groups. Early antibiotic discontinuation by day three occurred in 48% of the procalcitonin group versus 21% of usual care. Clinical cure at day 14 did not differ. Patients with severe immunosuppression were excluded. The protocol did not change time to first antibiotic dose among those treated. A small increase in return emergency visits within seven days was observed in both groups without a between-group difference.",
    "subclaim": "Protocol adherence exceeded ninety percent.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "Adults with community-acquired pneumonia were randomized.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "Procalcitonin guidance reduced total antibiotic days.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "ICU admission at presentation was an exclusion.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "Thirty-day readmission was similar between groups.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "Children were the primary population.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "Procalcitonin guidance increased antibiotic exposure.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "Readmissions were significantly lower with procalcitonin.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "Hospitals were exclusively rural.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "The trial was industry-funded.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "Macrolides were the most common antibiotics.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "The median age was 68 years.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 524 adults hospitalized with community-acquired pneumonia at five urban hospitals. Patients were assigned to a procalcitonin-guided antibiotic algorithm or usual care. The primary outcome was total antibiotic days within 30 days of randomization. Median antibiotic exposure was 5 days in the procalcitonin arm versus 8 days in control (p<0.001). Thirty-day mortality was 3.1% with procalcitonin and 3.4% with usual care, with no significant difference. Readmission within 30 days was similar between groups (11% vs 12%). Clostridioides difficile infection occurred less often in the procalcitonin group (1 vs 7 cases). Patients with severe immunosuppression or ICU admission at presentation were excluded. Adherence to the algorithm was 82% in the intervention arm. Length of stay did not differ between groups.",
    "subclaim": "Viral coinfection was present in 20% of patients.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Adults with type 2 diabetes on basal-bolus insulin were enrolled.",
    "label": "supported"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Continuous monitoring led to a larger HbA1c reduction at 6 months.",
    "label": "supported"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Severe hypoglycemia was less frequent with continuous monitoring.",
    "label": "supported"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Weight did not differ between groups.",
    "label": "supported"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "The trial was double-blind.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Only adolescents were included.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Total daily insulin increased with continuous monitoring.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Retention was below 70%.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Mean diabetes duration was 14 years.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Eighty percent used metformin.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Participants had advanced chronic kidney disease.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic open-label trial enrolled 300 adults with type 2 diabetes treated with basal-bolus insulin. Participants were randomized to continuous glucose monitoring or fingerstick self-monitoring of blood glucose. The primary outcome was change in HbA1c at 6 months. HbA1c fell by 1.1% with continuous monitoring versus 0.5% with fingersticks. Time in hypoglycemia (<70 mg/dL) decreased in the continuous monitoring group and was unchanged with fingersticks. Severe hypoglycemia events were fewer with continuous monitoring (2 vs 8). The cohort had a mean age of 62 years and 45% were female. Devices were factory-calibrated, and standardized training was provided. There was no significant difference in weight or total daily insulin between groups. Retention at 6 months was 94%.",
    "subclaim": "Cost-effectiveness of continuous monitoring was assessed.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Budesonide improved FEV1 more than montelukast.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Exacerbations needing oral steroids were fewer with budesonide.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Hoarseness was more frequent with budesonide.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Current smokers were excluded from the trial.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Montelukast produced a greater FEV1 increase than budesonide.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Emergency visits were reduced with budesonide versus montelukast.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Growth velocity was slower with budesonide.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Adults older than 18 were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Quality-of-life scores improved more with budesonide.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Nighttime symptoms decreased in both groups.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Blood eosinophil counts fell more with budesonide.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial compared inhaled budesonide 200 mcg twice daily with montelukast 10 mg nightly in adolescents with mild persistent asthma. Two hundred twenty participants aged 12–17 were treated for 24 weeks. The primary outcome was change in pre-bronchodilator FEV1 from baseline. Budesonide increased FEV1 by 9.2%, versus 4.1% with montelukast (p<0.001). Exacerbations requiring oral corticosteroids occurred in 8% with budesonide and 15% with montelukast (p=0.03). Emergency department visits were similar at 3% in both groups. Hoarseness and oral thrush were more frequent with budesonide (12% vs 3%). Growth velocity over six months did not differ between groups. Adherence was comparable (median 85% in each arm), and the trial excluded current smokers and those with severe asthma.",
    "subclaim": "Budesonide was more cost-effective than montelukast.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "The antibody reduced monthly migraine days versus placebo.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "The 50% responder rate was higher with the antibody.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "Injection-site reactions were more common with the antibody.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "Pregnant individuals were excluded.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "The trial used an open-label design.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "Participants had chronic migraine.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "Liver enzymes increased with the antibody.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "Blood pressure rose during treatment.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "Sleep quality improved with the antibody.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "The antibody was superior to topiramate.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "Benefits persisted for one year.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind, placebo-controlled trial, adults aged 18–65 with episodic migraine (4–14 days per month) received an anti-CGRP monoclonal antibody 225 mg monthly or placebo for 12 weeks. The primary endpoint was change in monthly migraine days during weeks 9–12. The antibody reduced monthly migraine days by a mean of 3.1 versus 1.4 with placebo (p<0.001). A 50% responder rate occurred in 47% on antibody and 23% on placebo. Acute medication days decreased by 2.0 with antibody versus 0.7 with placebo. Injection-site reactions were more common with the antibody (8% vs 3%). Serious adverse events were rare and similar between groups (1% each). Blood pressure and liver enzymes remained unchanged from baseline. Participants with uncontrolled hypertension or pregnancy were excluded.",
    "subclaim": "Treatment was cost-effective.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "Adults with moderate-to-severe atopic dermatitis were enrolled.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "Patients were randomized 2:1 to rilogitinib or placebo.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "EASI-75 at week 16 was higher with rilogitinib than with placebo.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "No venous thromboembolism occurred in the trial.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "Children under 12 were included.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "The comparator was cyclosporine instead of placebo.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "Pruritus scores worsened with rilogitinib.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "Serious infections were common with rilogitinib.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "Sleep quality improved more with rilogitinib than placebo.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "Baseline eosinophil count predicted response.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "Patients with asthma were excluded.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated rilogitinib, an oral JAK inhibitor, in adults aged 18–70 with moderate-to-severe atopic dermatitis. Participants were randomized 2:1 to rilogitinib 200 mg daily or placebo for 16 weeks across 14 European centers. The primary endpoint, EASI-75 at week 16, was achieved by 62% on rilogitinib versus 24% on placebo (p<0.001). Pruritus numeric rating scores improved by a mean of 4.1 points with rilogitinib and 1.6 with placebo. The most common adverse event was acne (9% vs 3%), and mild ALT elevations occurred in 3% vs 1%. No venous thromboembolism or serious infections were reported; two patients discontinued for headache. Patients with inflammatory bowel disease, active malignancy, or platelets <150,000/µL were excluded. Concomitant topical corticosteroids were permitted. Efficacy and safety in participants aged ≥60 were similar to the overall cohort.",
    "subclaim": "Drug levels were monitored weekly.",
    "label": "not_supported"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "The study was retrospective.",
    "label": "supported"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "Delirium incidence was lower with regional than with general anesthesia.",
    "label": "supported"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "Thirty-day mortality did not differ between anesthesia groups.",
    "label": "supported"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "Time to first mobilization was shorter with regional anesthesia.",
    "label": "supported"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "The study was a randomized trial.",
    "label": "refuted"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "All patients were under 50 years old.",
    "label": "refuted"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "Regional anesthesia had higher delirium than general anesthesia.",
    "label": "refuted"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "Regional patients had significant delays to surgery compared with general.",
    "label": "refuted"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "Use of tranexamic acid differed between groups.",
    "label": "not_supported"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "Dementia modified the effect of anesthesia type on delirium.",
    "label": "not_supported"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "ICU length of stay was reduced with regional anesthesia.",
    "label": "not_supported"
  },
  {
    "text": "At two hospitals, a retrospective cohort studied patients aged 65 years or older undergoing hemiarthroplasty for hip fracture. Anesthesia type was regional (spinal/epidural) or general by anesthesia team preference. The primary outcome was in-hospital delirium assessed by the Confusion Assessment Method, occurring in 22% with regional vs 34% with general anesthesia (adjusted OR 0.56, p=0.01). Thirty-day mortality did not differ between groups (6% vs 7%, p=0.64). Time to first mobilization was shorter with regional anesthesia (median 1 vs 2 days). Intraoperative hypotension was more frequent with general anesthesia (48% vs 35%). Time from admission to surgery was similar in both groups (median 18 hours). Fascia iliaca nerve blocks were used in 41% of regional cases for analgesia. Patients with polytrauma or pathologic fractures were excluded.",
    "subclaim": "Regional anesthesia reduced postoperative pneumonia rates.",
    "label": "not_supported"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "The trial enrolled outpatients with community-acquired pneumonia.",
    "label": "supported"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "The 5-day regimen was noninferior for day-14 clinical cure.",
    "label": "supported"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "Diarrhea rates were similar between arms.",
    "label": "supported"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "No Clostridioides difficile cases occurred.",
    "label": "supported"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "The 7-day group had higher cure than the 5-day group.",
    "label": "refuted"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "Many participants were hospitalized during follow-up.",
    "label": "refuted"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "Serious adverse events were common.",
    "label": "refuted"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "The trial was double-blind.",
    "label": "refuted"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "Radiographic resolution at 30 days was assessed.",
    "label": "not_supported"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "Procalcitonin guided antibiotic duration.",
    "label": "not_supported"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "Macrolide co-therapy was permitted.",
    "label": "not_supported"
  },
  {
    "text": "At three urban clinics, we conducted an open-label randomized trial in 480 adults with uncomplicated community-acquired pneumonia treated as outpatients. Participants received either high-dose amoxicillin/clavulanate for 5 days (1000/125 mg every 8 hours) or standard-dose for 7 days (875/125 mg every 12 hours). Baseline severity by CURB-65 and common comorbidities were balanced between arms. The primary endpoint, clinical cure at day 14 without rescue antibiotics, was 84% in the 5-day group and 82% in the 7-day group, meeting a prespecified 10% noninferiority margin. Time to resolution of fever was similar across groups. Diarrhea occurred in 15% vs 16%, and no cases of Clostridioides difficile were detected. Serious adverse events were rare and deemed unrelated to study drugs. In participants aged 65 years or older, cure rates did not differ between regimens. No participant required hospitalization during 21 days of follow-up.",
    "subclaim": "Smoking status differed across arms.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "All participants received ACEi/ARB background therapy.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "Finerenone reduced UACR more than placebo at 6 months.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "Hyperkalemia was more frequent with finerenone.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "Heart failure hospitalization rates did not differ.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "Finerenone lowered systolic blood pressure by about 10 mmHg.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "Placebo had a slower eGFR decline than finerenone.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "Mortality was higher with finerenone.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "Patients with baseline potassium 5.2 mmol/L were included.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "The trial was international.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "SGLT2 inhibitor use was balanced between groups.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "Finerenone improved diabetic retinopathy.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, randomized, double-blind study, 320 adults with type 2 diabetes and chronic kidney disease stages 2–3 with albuminuria received background maximally tolerated ACE inhibitor or ARB therapy. Participants were assigned to finerenone or matching placebo for 12 months. The primary outcome, percent change in urine albumin-to-creatinine ratio at month 6, favored finerenone (median -28%) over placebo (-8%). The annualized eGFR slope was less negative with finerenone (-2.4 mL/min/1.73 m²/year) than with placebo (-3.6). Hyperkalemia >5.5 mmol/L occurred in 14% of finerenone recipients and 5% of placebo, with few discontinuations. Mean systolic blood pressure decreased modestly and similarly in both groups (-3 vs -2 mmHg). Rates of hospitalization for heart failure and all-cause mortality were low and did not differ. Safety labs were checked monthly for 3 months then quarterly. Patients with baseline serum potassium above 4.8 mmol/L were excluded.",
    "subclaim": "The cohort's mean age was 72 years.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "A 0/1-hour high-sensitivity troponin T algorithm was implemented for ED chest pain.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "52% of patients were discharged without stress testing.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "Hospital admissions for chest pain decreased by 12%.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "The rule-out group had a 30-day MACE rate of 0.4%.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "ST-elevation myocardial infarction cases were included.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "Median ED length of stay increased after implementation.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "The algorithm increased hospital admissions.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "All patients underwent stress testing before discharge.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "Patient satisfaction scores improved after implementation.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "Twenty percent of participants had diabetes.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "Routine coronary CT angiography was performed for rule-out.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study evaluated the 0/1-hour high-sensitivity troponin T algorithm in emergency department adults presenting with chest pain. Among 1,842 patients (47% female; median age 58), 52% were discharged directly from the ED without stress testing. Thirty-day major adverse cardiac events (MACE) in the rule-out zone occurred in 0.4% of patients, with no deaths in that group. Overall 30-day MACE across all zones was 6.1%. After implementation, hospital admissions for chest pain decreased by 12% compared to the prior quarter. Median ED length of stay fell from 5.0 to 4.1 hours. Patients with estimated GFR below 45 mL/min/1.73 m² had more indeterminate troponin values and were less likely to be discharged the same day. ST-elevation myocardial infarction and hemodynamically unstable patients were excluded from enrollment.",
    "subclaim": "Ninety-day MACE rates were reduced.",
    "label": "not_supported"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "Adults with uncomplicated gram-negative bacteremia were randomized to 7 vs 14 days of antibiotics.",
    "label": "supported"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "Urinary sources accounted for 68% of infections.",
    "label": "supported"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "The 7-day regimen met noninferiority for the 30-day composite outcome.",
    "label": "supported"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "Antibiotic-related adverse events were lower with 7 days.",
    "label": "supported"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "The trial was blinded.",
    "label": "refuted"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "Neutropenic patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "Fourteen days had fewer adverse events than seven days.",
    "label": "refuted"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "Median time to defervescence was five days.",
    "label": "refuted"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "Median age of participants was 67 years.",
    "label": "not_supported"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "Pseudomonas aeruginosa was the most common pathogen.",
    "label": "not_supported"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "All patients received ceftriaxone as initial therapy.",
    "label": "not_supported"
  },
  {
    "text": "At six hospitals, an open-label randomized noninferiority trial compared 7 versus 14 days of antibiotics for adults with uncomplicated gram-negative bacteremia after source control. A total of 620 participants were assigned equally to each duration arm. Infection sources were urinary (68%), biliary (20%), and other sites. Patients with uncontrolled foci, neutropenia, or suspected endocarditis were excluded. The 30-day composite of death, relapse, or readmission occurred in 9.2% with 7 days and 10.1% with 14 days, meeting a 5% noninferiority margin. Antibiotic-related adverse events were lower with 7 days (12% vs 19%), mainly gastrointestinal. Oral step-down therapy after at least 3 days of intravenous treatment occurred in 62% overall. Clostridioides difficile infection was rare (1 case vs 2), and median time to defervescence was 2 days in both groups. Ninety-day follow-up showed similar recurrence rates between arms.",
    "subclaim": "Seven-day therapy reduced costs per patient.",
    "label": "not_supported"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "The trial was randomized and double-blind.",
    "label": "supported"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "Duloxetine reduced pain more than gabapentin at 12 weeks.",
    "label": "supported"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "Dizziness was more common with gabapentin than with duloxetine.",
    "label": "supported"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "Participants with eGFR below 45 mL/min were excluded.",
    "label": "supported"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "The study included adults younger than 40.",
    "label": "refuted"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "Gait speed improved significantly with duloxetine.",
    "label": "refuted"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "Falls were lower with gabapentin than with duloxetine.",
    "label": "refuted"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "Several cases of serotonin syndrome occurred in the duloxetine arm.",
    "label": "refuted"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "Concomitant opioid use was permitted.",
    "label": "not_supported"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "Women comprised over 70% of participants.",
    "label": "not_supported"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "The study was industry funded.",
    "label": "not_supported"
  },
  {
    "text": "A 12-week randomized, double-blind trial compared duloxetine 60 mg daily with gabapentin 300 mg three times daily in adults aged 60 years or older with painful diabetic peripheral neuropathy. The primary endpoint was change in the 11-point pain numeric rating scale at week 12. Patients with estimated glomerular filtration rate below 45 mL/min were excluded. Mean pain reduction was 2.3 points with duloxetine and 1.9 points with gabapentin, a between-group difference of 0.4 favoring duloxetine (p=0.04). Dizziness occurred in 12% on duloxetine versus 28% on gabapentin (p<0.01). Falls occurred in 7% on duloxetine and 9% on gabapentin, without a significant difference. Sleep interference scores improved similarly in both arms, and gait speed did not change. Discontinuation due to adverse events was 10% with duloxetine and 14% with gabapentin. No cases of serotonin syndrome were observed, and HbA1c remained unchanged.",
    "subclaim": "Mean baseline HbA1c exceeded 9%.",
    "label": "not_supported"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "Eligibility included adults 50-80 with at least 20 pack-years.",
    "label": "supported"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "The false-positive rate declined in the second screening round.",
    "label": "supported"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "The average radiation dose per scan was 1.4 mSv.",
    "label": "supported"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "No screening-related deaths were reported.",
    "label": "supported"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "Only current smokers were eligible.",
    "label": "refuted"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "Most detected cancers were stage III-IV.",
    "label": "refuted"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "Over 10% had major complications from invasive procedures.",
    "label": "refuted"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "Annual chest radiography was used instead of CT.",
    "label": "refuted"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "The program improved overall survival.",
    "label": "not_supported"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "Insurance coverage limited enrollment.",
    "label": "not_supported"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "PET-CT was mandatory before biopsy.",
    "label": "not_supported"
  },
  {
    "text": "At a community health system, a prospective low-dose CT lung cancer screening program enrolled 1,200 adults aged 50 to 80 years with at least 20 pack-years who were current smokers or had quit within 15 years. Participants underwent annual screening for two rounds. The primary metric was the proportion of cancers detected at stage I-II. In the first year, cancers were found in 2.1% of screened individuals, and 72% of cases were stage I-II. The false-positive rate was 21% in round one and fell to 12% in round two. Invasive diagnostic procedures were performed in 3% of participants, with a major complication rate of 0.3%. The average effective radiation dose per scan was 1.4 mSv. Smoking cessation counseling was provided to all, and 18% self-reported quitting by year two. No screening-related deaths occurred. Incidental coronary calcification led to statin initiation in 26 patients.",
    "subclaim": "Aspirin was routinely started for coronary calcification.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "HFNC reduced day-7 intubation versus conventional oxygen.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "Ninety-day mortality was similar between groups.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "Comfort at 24 hours was better with HFNC.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "Patients with PaO2/FiO2 <150 saw a larger intubation benefit.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "Patients with chronic hypercapnia were included.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "ICU length of stay was shorter with HFNC.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "Children were enrolled in the trial.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "HFNC caused frequent serious adverse events.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "HFNC reduced 30-day readmissions.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "Awake proning was mandated in both groups.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "HFNC lowered nosocomial infection rates.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated early high-flow nasal cannula (HFNC) versus conventional oxygen in adults with acute hypoxemic respiratory failure from pneumonia. Patients with chronic hypercapnia or cardiogenic pulmonary edema were excluded. A total of 312 patients (mean age 63) were randomized within 4 hours of emergency department arrival. HFNC targeted 50 L/min with SpO2 92–96%. The primary outcome, intubation by day 7, was lower with HFNC (28%) than control (40%), absolute risk difference 12%. Ninety-day mortality did not differ (19% vs 21%). Patient-reported dyspnea and device comfort were better with HFNC at 24 hours. ICU length of stay was similar between groups. In a prespecified subgroup with PaO2/FiO2 below 150, the intubation reduction was larger. Serious adverse events were rare and comparable.",
    "subclaim": "HFNC was cost-saving compared with standard oxygen.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "Five days of therapy was noninferior for day-14 clinical cure.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "GI adverse effects were less frequent with 5 days.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "Both C. difficile cases were in the 10-day arm.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "Intranasal steroids were allowed in both groups.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "The trial enrolled children with sinusitis.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "Five-day therapy caused more GI side effects than 10 days.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "Serious drug-related events were reported.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "Adjunctive intranasal steroids were prohibited.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "Sinus CT imaging guided enrollment.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "Smoking status modified cure rates.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "Recent antibiotic use was an exclusion criterion.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized noninferiority trial compared 5 days versus 10 days of amoxicillin-clavulanate in adults with acute bacterial sinusitis seen in primary care. Six hundred eighty-four participants (median age 41) were enrolled; those with penicillin allergy or severe immunosuppression were excluded. Adjunctive intranasal steroids and saline irrigations were permitted in both arms. The primary endpoint, clinical cure by day 14, met noninferiority with 5 days achieving 74% and 10 days 76%. Time to symptom relief did not differ between groups. Gastrointestinal adverse effects were less frequent with 5 days (18% vs 27%). Two cases of Clostridioides difficile occurred, both in the 10-day group. Relapse by day 28 and nasopharyngeal colonization with resistant organisms were similar. No serious drug-related events were reported.",
    "subclaim": "Five-day therapy was more cost-effective.",
    "label": "not_supported"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "The trial was conducted at eight centers.",
    "label": "supported"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "Pregnant patients were excluded.",
    "label": "supported"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "Procalcitonin guidance reduced antibiotic days.",
    "label": "supported"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "C. difficile infections were less frequent with procalcitonin.",
    "label": "supported"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "Median age was 40 years.",
    "label": "refuted"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "Antibiotic duration was longer in the procalcitonin arm.",
    "label": "refuted"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "The study was single-center.",
    "label": "refuted"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "Readmissions were higher with procalcitonin.",
    "label": "refuted"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "Viral PCR testing guided antibiotic decisions.",
    "label": "not_supported"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "ICU patients had greater benefit than ward patients.",
    "label": "not_supported"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "Procalcitonin results were available within one hour.",
    "label": "not_supported"
  },
  {
    "text": "An 8-center pragmatic trial evaluated procalcitonin-guided antibiotic discontinuation for adults with community-acquired pneumonia presenting to emergency departments and general wards. A total of 1,120 adults were enrolled, median age 66 years, 46% female. Patients who were immunocompromised, pregnant, or in refractory shock requiring vasopressors at enrollment were excluded. In the intervention arm, antibiotics were recommended to be stopped if procalcitonin was below 0.25 µg/L at 24–48 hours and declining; the control arm received usual care. The procalcitonin strategy reduced total antibiotic exposure, with a median of 5 days versus 7 days in controls. Thirty-day all-cause mortality (3.1% vs 3.4%) and hospital readmissions (12% vs 13%) were similar between groups. Clostridioides difficile infection occurred less often in the procalcitonin arm (0.7% vs 2.2%). Length of stay did not differ meaningfully between groups (4.3 vs 4.4 days). Algorithm adherence in the intervention arm was 78%, and no safety signals related to early discontinuation were identified.",
    "subclaim": "Macrolide resistance exceeded 25%.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Mean age was 56 years.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Most participants were female.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "ACR50 at 24 weeks was higher with tofacitinib than adalimumab.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Herpes zoster occurred more often with tofacitinib.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Patients with recent VTE were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Adalimumab achieved a higher ACR50 rate.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Radiographic progression was worse with tofacitinib.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Serious infections were markedly lower with tofacitinib.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Shingles vaccination was mandatory before randomization.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Average prednisone dose was 10 mg daily.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Radiographs were scored by two independent blinded readers.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared a Janus kinase inhibitor with a tumor necrosis factor inhibitor in adults with rheumatoid arthritis inadequately controlled on methotrexate. Six hundred twenty participants were assigned to tofacitinib plus background methotrexate or adalimumab plus background methotrexate. The mean age was 56 years, and 78% were female; smoking status was balanced between groups. Patients with a venous thromboembolism in the prior six months were excluded. At week 24, ACR50 was achieved in 48% on tofacitinib versus 42% on adalimumab. Rates of serious infection were similar (2.6% vs 2.1%), but herpes zoster was more frequent with tofacitinib (3.5% vs 1.1%). Mean LDL cholesterol increased by 8 mg/dL with tofacitinib, while hemoglobin remained stable in both arms. Radiographic progression of joint damage through 24 weeks was similar between groups, and venous thromboembolism events were infrequent (3 vs 1).",
    "subclaim": "Asian patients had the highest ACR50 rate.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "Dapagliflozin lowered the composite of CV death or HF hospitalization at 12 months.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "KCCQ score improved with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "Genital mycotic infections were more frequent with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "Benefits were similar in participants with and without diabetes.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "Patients with eGFR below 30 mL/min/1.73 m² were included.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "Hypoglycemia was more common with dapagliflozin than placebo.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "NT-proBNP did not change with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "Only patients older than 85 years were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "All-cause mortality was reduced by dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "Sixty percent of participants were women.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "Mean baseline ejection fraction was 25%.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized, double-blind trial compared dapagliflozin 10 mg daily with placebo in adults with heart failure with reduced ejection fraction. 1,208 participants aged 45–85 years received optimized background therapy including ACE inhibitors or ARNI, beta-blockers, and loop diuretics. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure at 12 months. Dapagliflozin reduced the risk of the primary outcome by 22% relative to placebo, with consistent effects in patients with and without diabetes. Health status improved, with a mean 8-point increase in KCCQ scores and a modest gain in 6-minute walk distance in the active arm. NT-proBNP concentrations declined and the rate of eGFR decline was slower with dapagliflozin. Adverse events included more genital mycotic infections and slightly more volume depletion, without excess hypoglycemia or ketoacidosis. The trial excluded pregnant individuals and those with an eGFR below 30 mL/min/1.73 m².",
    "subclaim": "Benefits persisted for 24 months.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "Lung ultrasound sensitivity was 92% for pneumonia.",
    "label": "supported"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "An ultrasound-first strategy reduced radiograph use by about 45%.",
    "label": "supported"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "Ultrasound false positives often reflected atelectasis.",
    "label": "supported"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "Immunocompromised children were excluded.",
    "label": "supported"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "Operators completed a 40-hour training course.",
    "label": "refuted"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "Chest radiography had higher sensitivity than ultrasound.",
    "label": "refuted"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "Antibiotic prescribing increased after adopting ultrasound-first.",
    "label": "refuted"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "Ultrasound caused skin burns in several children.",
    "label": "refuted"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "The median age was 6 years.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "Handheld ultrasound devices were used.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "Inter-observer agreement for ultrasound was kappa 0.8.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study in a pediatric emergency department evaluated point-of-care lung ultrasound for diagnosing community-acquired pneumonia against chest radiography. The cohort included 380 children aged 2–12 years presenting with fever and cough who were hemodynamically stable. Pediatricians performed ultrasound after a 4-hour training workshop, and radiologists interpreted chest radiographs blinded to ultrasound results. The reference standard was final adjudication by two pediatric infectious disease specialists at 7-day follow-up using all available clinical data. Lung ultrasound sensitivity for pneumonia was 92% with specificity of 78%, whereas chest radiography had 85% sensitivity and 88% specificity. Implementing an ultrasound-first pathway reduced radiograph use by 45% and shortened emergency department length of stay by a median of 30 minutes. False positives on ultrasound were commonly due to subsegmental atelectasis, and no adverse events from ultrasound occurred. Children who were immunocompromised or required immediate intensive care were excluded from enrollment. Overall antibiotic prescribing rates did not change compared with the pre-implementation period.",
    "subclaim": "Hospital admission rates decreased with ultrasound-first.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "The trial enrolled HFrEF patients with LVEF ≤35%.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "At 12 months, the composite of CV death or HF hospitalization was lower with zariflozin.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "Genital mycotic infections were more frequent with zariflozin than with placebo.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "eGFR changes were similar between zariflozin and placebo.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "The trial enrolled patients with LVEF ≥50%.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "Type 1 diabetes patients were included.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "Zariflozin increased systolic blood pressure by 5 mmHg.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "Zariflozin caused a greater decline in eGFR than placebo.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "All-cause mortality was reduced by zariflozin.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "Outcomes at 24 months favored zariflozin.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "All-cause hospital readmissions decreased with zariflozin.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 1,200 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤35%) were randomized to zariflozin 10 mg daily or placebo on top of guideline-directed therapy. Participants were 45–85 years old and mostly receiving a beta blocker and an ACE inhibitor or ARNI at baseline. At 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 20% with zariflozin versus 28% with placebo, driven by fewer hospitalizations. Cardiovascular mortality alone was similar between groups. Genital mycotic infections occurred in 4% on zariflozin and 1% on placebo. Mean systolic blood pressure fell by about 3 mmHg with zariflozin compared to placebo. Changes in estimated glomerular filtration rate were mild and comparable between arms, including in the subgroup with baseline eGFR 30–45 mL/min/1.73 m². Type 1 diabetes and recent ketoacidosis were exclusion criteria. Definite diabetic ketoacidosis was rare (0.2% in each group).",
    "subclaim": "Health-related quality of life improved on zariflozin.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "Lung ultrasound sensitivity for pneumonia was 93%.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "Time to diagnostic decision was shorter with ultrasound than with radiography.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "An ultrasound-first pathway avoided chest radiographs in 62% of children.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "No serious adverse events from ultrasound were reported.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "Adults over 18 years were included in the study.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "Operators required 40 hours of training to perform ultrasound.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "Chest radiography had higher sensitivity than ultrasound.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "Inter-operator agreement for ultrasound was kappa 0.3.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "Hospital length of stay was shorter with ultrasound.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "Ultrasound reduced per-patient diagnostic costs.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "Outpatient revisit rates decreased with ultrasound.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective emergency department study of 320 children aged 3 months to 12 years with suspected community-acquired pneumonia. Clinicians performed lung ultrasound after an 8-hour training module and obtained chest radiographs when clinically indicated. A blinded adjudication committee, using clinical follow-up and labs, served as the reference standard. Lung ultrasound sensitivity for pneumonia was 93% and specificity 86%, while chest radiography showed 88% sensitivity and 92% specificity. Median time to diagnostic decision was 18 minutes with ultrasound versus 52 minutes with radiography. Using an ultrasound-first pathway, 62% of children avoided any chest radiograph, reducing radiation exposure. Inter-operator agreement for ultrasound was moderate to substantial (kappa 0.78). No serious adverse events related to ultrasound were reported during the study.",
    "subclaim": "Ultrasound detected pleural effusions more accurately than CT.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "ICS reduced COPD exacerbations by about 25%.",
    "label": "supported"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "Oropharyngeal candidiasis was higher with ICS.",
    "label": "supported"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "All-cause mortality was similar between groups.",
    "label": "supported"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "Mean FEV1 increased more with ICS than placebo.",
    "label": "supported"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "Patients younger than 50 years were included.",
    "label": "refuted"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "Systolic blood pressure rose with ICS.",
    "label": "refuted"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "Pneumonia was more frequent with ICS.",
    "label": "refuted"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "Home oxygen use increased during the trial.",
    "label": "refuted"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "ICS shortened length of hospital stay for exacerbations.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "Adherence exceeded 95% in both arms.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "The trial was industry-funded.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind multicenter trial enrolled 480 adults aged 60–82 years with moderate-to-severe COPD. All participants received background long-acting bronchodilators and were randomized to inhaled corticosteroid (ICS) 200 μg twice daily or matching placebo for 12 months. The ICS group had a 25% lower annualized rate of moderate-to-severe exacerbations than placebo (0.90 vs 1.20 events per patient-year, p=0.01). All-cause mortality did not differ (2.0% vs 2.5%, p=0.70). Mean FEV1 rose by 80 mL with ICS versus 10 mL with placebo (between-group difference 70 mL). Oropharyngeal candidiasis occurred more often with ICS (6% vs 1%). Rates of new-onset diabetes, pneumonia, and systolic blood pressure were similar between groups. Benefits were consistent in current and former smokers, and no interaction by baseline eosinophils was detected. Home oxygen use was 15% in both arms at baseline and remained unchanged at study end.",
    "subclaim": "ICS caused clinically significant weight gain.",
    "label": "not_supported"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "Pregnant patients were excluded.",
    "label": "supported"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "Time to discharge decreased with the 0/1-hour algorithm.",
    "label": "supported"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "The rule-out NPV for 30-day MI or death was 99.8%.",
    "label": "supported"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "Specificity was lower in chronic kidney disease.",
    "label": "supported"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "The new algorithm increased 30-day MACE.",
    "label": "refuted"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "Return ED visits within 72 hours increased.",
    "label": "refuted"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "Per-patient costs rose after implementation.",
    "label": "refuted"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "ECG was not used for immediate rule-in.",
    "label": "refuted"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "The study reduced inpatient mortality.",
    "label": "not_supported"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "Median age of participants was 68 years.",
    "label": "not_supported"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "Cardiac MRI was part of the rule-out pathway.",
    "label": "not_supported"
  },
  {
    "text": "Two urban emergency departments prospectively evaluated a 0/1-hour high-sensitivity troponin algorithm for adults with chest pain. Patients with ST-elevation myocardial infarction or pregnancy were excluded. Across 1,000 participants, 54% were ruled out within 90 minutes, and the negative predictive value for 30-day myocardial infarction or cardiac death was 99.8%. Compared with the prior 0/3-hour strategy, median time to discharge fell from 7.2 hours to 4.1 hours. Thirty-day major adverse cardiac events were similar between periods (2.1% vs 2.3%). Specificity was lower in chronic kidney disease (eGFR <60 mL/min/1.73 m2), though sensitivity remained 100%. Return emergency visits within 72 hours did not increase. Per-patient costs decreased by about $180 due to fewer observation admissions. Immediate rule-in required ECG evidence of ischemia alongside troponin criteria. Patient satisfaction scores improved modestly after implementation.",
    "subclaim": "A 2-hour troponin protocol outperformed the 1-hour approach.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "Adults 65 or older were enrolled.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "ICU patients at presentation were excluded.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "The 5-day regimen was noninferior for day-14 clinical cure.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "C. difficile infections were fewer in the 5-day group.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "The trial enrolled children.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "The 7-day group had a shorter median length of stay.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "Thirty-day mortality was higher in the 5-day arm.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "The primary endpoint was radiographic resolution.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "Patients with chronic kidney disease were excluded.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "Smoking status differed between groups.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "Corticosteroids were used routinely.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 612 hospitalized adults aged 65 years or older with community-acquired pneumonia not requiring ICU care. Participants were assigned to a 5-day versus a 7-day beta-lactam plus macrolide regimen. The primary endpoint was clinical cure at day 14 with a noninferiority margin of 10%. Clinical cure occurred in 86% of the 5-day group and 84% of the 7-day group, meeting noninferiority. Thirty-day all-cause mortality was 3% in the 5-day group and 4% in the 7-day group, with no significant difference. Clostridioides difficile infection occurred in 1 patient in the 5-day group and 5 patients in the 7-day group. Median hospital length of stay was 4 days in both groups. Antibiotic-associated diarrhea occurred in 7% versus 12%, favoring the shorter course. Readmission within 30 days was similar at 11% and 12%. Exclusions included ICU admission at presentation, recent hospitalization within 14 days, and severe immunosuppression.",
    "subclaim": "Sputum cultures identified S. pneumoniae in half of cases.",
    "label": "not_supported"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "Adults with suspected ACS in the ED were studied.",
    "label": "supported"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "A 0/1-hour high-sensitivity troponin I algorithm increased early discharge.",
    "label": "supported"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "Thirty-day MI or death in the rule-out group was 0.3%.",
    "label": "supported"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "Patients with eGFR below 30 were excluded.",
    "label": "supported"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "The assay measured troponin T.",
    "label": "refuted"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "Pediatric patients were included.",
    "label": "refuted"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "The algorithm reduced length of stay among rule-in patients.",
    "label": "refuted"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "Overall 30-day mortality decreased significantly after implementation.",
    "label": "refuted"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "The study reported cost savings.",
    "label": "not_supported"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "Women had higher false-positive results.",
    "label": "not_supported"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "The HEART score was used for all patients.",
    "label": "not_supported"
  },
  {
    "text": "A prospective before-after study evaluated a 0/1-hour high-sensitivity troponin I algorithm in two urban emergency departments. The cohort included 3,420 adults with suspected non–ST-elevation acute coronary syndrome. Rule-out criteria were a baseline troponin I <5 ng/L and a 1-hour delta <2 ng/L; rule-in required values above the 99th percentile or a rise >5 ng/L. The primary outcomes were discharge within 3 hours and 30-day myocardial infarction or death in the rule-out group. After implementation, early discharge increased from 22% to 48%. Thirty-day myocardial infarction or death occurred in 0.3% of rule-out patients. Length of stay for rule-in patients was unchanged with a median of 12 hours pre- and post-implementation. Exclusions included estimated GFR <30 mL/min/1.73 m2, pregnancy, and age under 18. Overall 30-day mortality for the cohort was unchanged compared with the pre-implementation period.",
    "subclaim": "A prehospital ECG was required for enrollment.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "Participants were 65 or older.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "The trial compared ceftriaxone plus azithromycin to levofloxacin alone.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "C. difficile colitis was less common with the combination regimen.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "Median antibiotic duration was 7 days in both groups.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "Levofloxacin achieved faster clinical stability than the combination.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "Systemic corticosteroids were routinely given.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "MRSA pneumonia cases were included.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "Only outpatients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "Legionella was the most common pathogen.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "Renal dysfunction was more frequent with levofloxacin.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "Prior pneumococcal vaccination reduced mortality.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared ceftriaxone plus azithromycin with levofloxacin monotherapy in older adults hospitalized for community-acquired pneumonia. All 320 participants were aged 65 years or older and had type 2 diabetes. Median time to clinical stability was 3.2 days with the combination and 3.5 days with levofloxacin (p=0.09). Thirty-day mortality was similar between groups at 6% versus 7%. Clostridioides difficile colitis occurred in 2% with the combination and 5% with levofloxacin (p=0.04). QT prolongation was infrequent (4% vs 2%) and not statistically different. Systemic corticosteroids were not used, and cases due to MRSA were excluded. The median antibiotic course was 7 days in both arms, and most patients achieved discharge by day 5.",
    "subclaim": "The trial had pharmaceutical industry funding.",
    "label": "not_supported"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "A 0/1-hour hs-troponin I algorithm was used.",
    "label": "supported"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "Fifty-nine percent were ruled out at 1 hour.",
    "label": "supported"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "Length of stay decreased after implementation.",
    "label": "supported"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "Antiplatelet therapy was not required by the protocol.",
    "label": "supported"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "Only patients with ST-elevation were included.",
    "label": "refuted"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "Hospital admission increased after the protocol change.",
    "label": "refuted"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "Sensitivity fell below 90% in chronic kidney disease.",
    "label": "refuted"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "The assay did not need validation.",
    "label": "refuted"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "The median age was 65 years.",
    "label": "not_supported"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "Beta-blocker use altered test performance.",
    "label": "not_supported"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "The study was randomized.",
    "label": "not_supported"
  },
  {
    "text": "An emergency department implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm for ruling out myocardial infarction in adults with chest pain. Among 950 consecutive patients without ST-elevation, 59% met rule-out criteria at 1 hour. In the rule-out group, 30-day myocardial infarction or cardiac death occurred in 0.3% (95% CI 0.0–0.8). Compared with the prior 0/3-hour protocol, median length of stay fell from 6.1 to 4.2 hours. Hospital admission decreased from 71% to 52% without an increase in missed infarctions. Estimated specificity was lower in patients with chronic kidney disease, but sensitivity remained above 98%. Antiplatelet therapy was not mandated by the protocol and left to clinician judgment. The algorithm was applied equally to men and women and required a validated high-sensitivity assay. Troponin samples were processed in the hospital laboratory within 30 minutes of collection.",
    "subclaim": "Echocardiography was mandatory before discharge.",
    "label": "not_supported"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "The 5-day prednisone course was noninferior to 14 days for time to next exacerbation.",
    "label": "supported"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "Hyperglycemia requiring insulin was less frequent with the 5-day regimen.",
    "label": "supported"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "Length of stay was similar between groups.",
    "label": "supported"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "Patients on chronic systemic steroids were excluded.",
    "label": "supported"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "The 5-day regimen prolonged hospital stay.",
    "label": "refuted"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "The 14-day regimen reduced insomnia compared with 5 days.",
    "label": "refuted"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "Ninety-day mortality was higher with the 5-day course.",
    "label": "refuted"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "Antibiotics were not used in the trial.",
    "label": "refuted"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "Quality-of-life scores improved more with 5 days.",
    "label": "not_supported"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "ICU admission rates differed between groups.",
    "label": "not_supported"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "Median age was 68 years.",
    "label": "not_supported"
  },
  {
    "text": "At five tertiary hospitals, a randomized trial enrolled 412 adults with acute COPD exacerbations requiring emergency care or admission. Participants received prednisone 40 mg daily for either 5 days or 14 days, plus inhaled bronchodilators and oxygen as needed. Guideline-concordant antibiotics were provided at clinician discretion. The primary outcome was time to next exacerbation within 90 days, for which the 5-day course was noninferior to 14 days. Secondary outcomes showed similar length of stay and similar improvements in FEV1 between groups. Hyperglycemia requiring rescue insulin was less frequent in the 5-day arm. There was no difference in 90-day mortality or in new-onset pneumonia. Insomnia was reported more often with the 14-day regimen, and patients on chronic systemic steroids were excluded; follow-up was 96% complete.",
    "subclaim": "A crossover design was used.",
    "label": "not_supported"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "hs-cTnI was measured at 0 and 1 hour.",
    "label": "supported"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "The rule-out group had a 0.3% 30-day MI or cardiac death rate.",
    "label": "supported"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "The algorithm reduced median ED length of stay by about 1.8 hours.",
    "label": "supported"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "Patients with eGFR below 30 mL/min/1.73 m² were excluded.",
    "label": "supported"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "Sex-specific troponin thresholds were applied.",
    "label": "refuted"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "No ECGs were obtained.",
    "label": "refuted"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "The rule-out group's NPV was below 95%.",
    "label": "refuted"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "Angiography increased in the observe group after implementation.",
    "label": "refuted"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "Mean age was 64 years.",
    "label": "not_supported"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "Costs per patient decreased with implementation.",
    "label": "not_supported"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "Ninety-day outcomes were assessed.",
    "label": "not_supported"
  },
  {
    "text": "Three urban emergency departments prospectively enrolled 1,200 adults presenting with chest pain of possible cardiac origin. A high-sensitivity troponin I protocol measured levels at presentation and 1 hour, coupled with clinical assessment using a HEART score. Patients were categorized as rule-out, observe, or rule-in by predefined thresholds; sex-specific cutoffs were not used. The primary endpoint was 30-day myocardial infarction or cardiac death. Among rule-out patients, the event rate was 0.3%, yielding a negative predictive value of 99.7%. Compared with prior practice, implementing the algorithm shortened median emergency department stay by 1.8 hours. There was no increase in missed type 1 myocardial infarction; most false negatives were later adjudicated as myocarditis. Downstream coronary angiography rates in the observe group did not change. Patients with estimated GFR under 30 mL/min/1.73 m² were excluded, and all had serial ECGs.",
    "subclaim": "Coronary CT angiography was mandated by the protocol.",
    "label": "not_supported"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "Triple therapy lowered severe asthma exacerbations versus dual therapy.",
    "label": "supported"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "FEV1 improved by about 0.11 L with triple versus dual at week 24.",
    "label": "supported"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "Treatment continued for 48 weeks.",
    "label": "supported"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "Oral candidiasis was more common with triple therapy.",
    "label": "supported"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "Current smokers were enrolled.",
    "label": "refuted"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "Pneumonia was more frequent with triple therapy.",
    "label": "refuted"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "Participants were children under 12 years.",
    "label": "refuted"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "Hospitalizations were higher with triple therapy.",
    "label": "refuted"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "The study was industry funded.",
    "label": "not_supported"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "Adherence exceeded 90%.",
    "label": "not_supported"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "Quality-of-life scores improved.",
    "label": "not_supported"
  },
  {
    "text": "The AERIS study randomized 420 adults aged 18–70 with moderate-to-severe asthma uncontrolled on inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) to receive once-daily inhaled triple therapy (ICS/LABA/long-acting muscarinic antagonist) or to continue ICS/LABA. Treatment continued for 48 weeks with clinic visits every 8 weeks. Triple therapy reduced the annualized severe exacerbation rate by 28% compared with dual therapy. In a prespecified subgroup, participants with higher blood eosinophil counts saw the largest risk reductions. Mean pre-bronchodilator FEV1 at week 24 improved by 110 mL in the triple-therapy arm relative to dual therapy. Rates of oral candidiasis were higher with triple therapy, but discontinuations for adverse events were rare in both groups. Pneumonia occurred infrequently and at similar rates across arms. Current smokers and patients with physician-diagnosed COPD overlap were excluded from enrollment. Hospitalizations for asthma were fewer in the triple-therapy group than in the dual-therapy group.",
    "subclaim": "A blood eosinophil threshold of 300 cells/µL defined response.",
    "label": "not_supported"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "The 0/1-hour troponin pathway reduced emergency department length of stay.",
    "label": "supported"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "More patients were discharged directly under the new pathway.",
    "label": "supported"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "Dialysis patients were excluded from the pathway.",
    "label": "supported"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "The rule-out group had a 30-day MI rate of 0.3%.",
    "label": "supported"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "Thirty-day mortality increased after implementation.",
    "label": "refuted"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "The pathway used a 3-hour troponin protocol.",
    "label": "refuted"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "Patients with clearly ischemic ECGs were included.",
    "label": "refuted"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "Unplanned revascularization rose after the change.",
    "label": "refuted"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "The study was randomized.",
    "label": "not_supported"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "Point-of-care troponin analyzers were used.",
    "label": "not_supported"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "The rule-out threshold was 5 ng/L.",
    "label": "not_supported"
  },
  {
    "text": "The RAPID-HS program introduced a 0/1-hour high-sensitivity troponin I pathway for adults presenting with possible acute coronary syndrome across three urban emergency departments. Patients with clearly ischemic ECGs or on chronic dialysis were excluded from the pathway. Compared with the prior 3-hour conventional troponin protocol, median emergency department length of stay fell by 2.1 hours after implementation. Under the new pathway, 55% of patients were discharged directly from the emergency department versus 38% before. Among patients classified as rule-out by the pathway, the 30-day myocardial infarction rate was 0.3%, yielding a negative predictive value of 99.7%. Sensitivity for index myocardial infarction detection was 98.8% with the high-sensitivity protocol. Thirty-day all-cause mortality did not differ between the two periods. Rates of unplanned coronary revascularization within 30 days were similar before and after implementation. The intervention did not change the proportion given aspirin at discharge.",
    "subclaim": "The intervention improved patient satisfaction scores.",
    "label": "not_supported"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "Triple therapy reduced exacerbations versus dual therapy.",
    "label": "supported"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "FEV1 improved by 80 mL with triple therapy vs dual at week 24.",
    "label": "supported"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "Oral candidiasis was more frequent with triple therapy.",
    "label": "supported"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "The mean participant age was 66 years.",
    "label": "supported"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "Most participants were current smokers.",
    "label": "refuted"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "Triple therapy increased pneumonia risk.",
    "label": "refuted"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "Triple therapy lowered all-cause mortality.",
    "label": "refuted"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "Asthma patients were eligible for enrollment.",
    "label": "refuted"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "The trial evaluated cost-effectiveness.",
    "label": "not_supported"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "Quality-of-life scores were reported.",
    "label": "not_supported"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "Eosinophil counts predicted treatment benefit.",
    "label": "not_supported"
  },
  {
    "text": "An industry-sponsored randomized, double-blind trial evaluated an inhaled once-daily triple therapy (inhaled corticosteroid/long-acting beta-agonist/long-acting muscarinic antagonist) in 620 adults with moderate-to-severe COPD. Participants were 58% male with a mean age of 66 years; all had at least one moderate exacerbation in the prior year and were former smokers. Patients received either triple therapy or a dual bronchodilator (LABA/LAMA) for 48 weeks. The primary endpoint, annualized rate of moderate or severe exacerbations, was 0.92 with triple therapy versus 1.23 with dual therapy, a 25% relative reduction. Prebronchodilator FEV1 improved by 80 mL at week 24 in the triple therapy arm compared with dual therapy. All-cause mortality did not differ between groups. Oral candidiasis occurred more often with triple therapy (7% vs 2%), while pneumonia rates were similar. Rescue albuterol use declined in both groups, but more in the triple therapy arm. The protocol excluded patients with asthma or alpha-1 antitrypsin deficiency.",
    "subclaim": "Hospital length of stay decreased with triple therapy.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "Procalcitonin guidance reduced antibiotic days by about 2.1 days.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "Thirty-day mortality did not increase with the algorithm.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "C. difficile infections were less frequent with the algorithm.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "Severely immunosuppressed patients were excluded.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "The trial enrolled 1200 adults.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "The algorithm led to more ICU transfers.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "Hospital stay was shorter with procalcitonin guidance.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "Stopping antibiotics required procalcitonin above 0.5 ng/mL.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "The study was industry funded.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "Baseline procalcitonin averaged 0.8 ng/mL.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "A fingerstick device measured procalcitonin.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated randomized trial tested a procalcitonin-guided algorithm for antibiotic duration in 450 adults hospitalized with suspected lower respiratory tract infection. Median age was 61 years; 49% were women. Patients were allocated to procalcitonin guidance or usual care for antibiotic decisions. The algorithm advised withholding or stopping antibiotics when procalcitonin was below 0.25 ng/mL or fell by 80% from baseline. Over 30 days, antibiotic exposure was reduced by 2.1 days in the procalcitonin arm without an increase in mortality or ICU transfer. Rates of Clostridioides difficile infection were lower with the algorithm (1% vs 4%). Time to clinical stability and hospital length of stay were similar between groups. Adherence to the algorithm was 82%. Patients with severe immunosuppression or cystic fibrosis were excluded.",
    "subclaim": "Ninety-day quality of life improved with the algorithm.",
    "label": "not_supported"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "Fluticasone escalation lowered exacerbation rates more than montelukast.",
    "label": "supported"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "FEV1 improved more with fluticasone than with montelukast.",
    "label": "supported"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "Nighttime symptoms improved in both treatment arms.",
    "label": "supported"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "Oral thrush was more frequent with higher-dose fluticasone.",
    "label": "supported"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "Montelukast reduced exacerbations more than fluticasone.",
    "label": "refuted"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "Serious adverse events occurred only in the montelukast arm.",
    "label": "refuted"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "Current smokers were included.",
    "label": "refuted"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "Mean adherence was below 60%.",
    "label": "refuted"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "Participants had a mean BMI of 35 kg/m2.",
    "label": "not_supported"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "Nasal symptom scores improved more with montelukast.",
    "label": "not_supported"
  },
  {
    "text": "At six academic centers, 240 adults aged 18–65 with moderate persistent asthma and perennial allergic rhinitis on low-dose inhaled corticosteroids were randomized. Participants received either add-on montelukast 10 mg nightly or a doubled dose of inhaled fluticasone for 24 weeks. The primary outcome, annualized exacerbation rate, was lower with fluticasone escalation than with montelukast (0.6 vs 0.9; rate ratio 0.67; p=0.01). Prebronchodilator FEV1 increased more in the fluticasone group (+220 mL) than in the montelukast group (+120 mL). Nighttime symptom scores declined similarly in both arms. Fractional exhaled nitric oxide decreased modestly in both groups without a significant between-group difference. Serious adverse events were rare and balanced; oral thrush was more frequent with higher-dose fluticasone, and headaches were slightly more common with montelukast. Current smokers and pregnant individuals were excluded. Adherence exceeded 85% in both arms.",
    "subclaim": "Blood eosinophil counts fell only with fluticasone.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "1,200 adults with chest pain and no ST-elevation were enrolled.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "A 0/1-hour high-sensitivity troponin I algorithm was used.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "Fifty-eight percent were assigned to the rule-out zone.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "The rule-out zone had a 99.7% negative predictive value.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "The primary outcome was 90-day mortality.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "There were zero 30-day events in the rule-out group.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "Women had worse safety outcomes than men.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "All patients received study-mandated aspirin.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "Median time from symptom onset to first blood draw was 2 hours.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "The observe group had a median length of stay of 12 hours.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "The study was funded by the assay manufacturer.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort across five emergency departments enrolled 1,200 adults presenting with chest pain and no ST-elevation on ECG. High-sensitivity troponin I was measured at presentation and 1 hour, using a 0/1-hour algorithm classifying patients as rule-out, observe, or rule-in. The primary outcome was 30-day myocardial infarction or cardiac death adjudicated by blinded cardiologists. Fifty-eight percent of patients were categorized as rule-out and discharged from the ED. Among rule-out patients, 30-day myocardial infarction or cardiac death occurred in 0.3% (2 of 696). The negative predictive value for the rule-out zone was 99.7% (95% CI 99.0–99.9). Safety outcomes were similar in women and men, while adults over 75 years had a lower rule-out proportion. Two patients classified as rule-out experienced non–ST-elevation myocardial infarction within 24 hours of discharge. No study-mandated antiplatelet therapy was provided; management followed local protocols.",
    "subclaim": "One-year outcomes were tracked.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "Adults aged 18–65 were enrolled.",
    "label": "supported"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "The antibody reduced monthly migraine days more than placebo at 12 weeks.",
    "label": "supported"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "Constipation was more frequent with the antibody than with placebo.",
    "label": "supported"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "Triptans were allowed as acute rescue therapy.",
    "label": "supported"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "Pregnant patients were included.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "Botulinum toxin for prevention was permitted.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "Serious drug-related adverse events were common.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "The antibody increased blood pressure.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "The drug reduced days with aura.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "Quality-of-life scores improved.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "Emergency department visits decreased.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, randomized, double-blind trial evaluated a monthly 70 mg subcutaneous anti-CGRP monoclonal antibody versus placebo for episodic migraine prevention. Adults aged 18 to 65 years with 4 to 14 monthly migraine days were enrolled, and pregnant patients were excluded. Rescue triptans were allowed, and patients could remain on stable preventive medications except botulinum toxin and other monoclonal antibodies. The primary endpoint was change in mean monthly migraine days at week 12. The antibody group improved by 2.3 days versus 1.0 days with placebo, yielding a between-group difference of 1.3 days (p<0.01). Fifty percent responder rates were 42% for the antibody and 23% for placebo. Injection site pain occurred in 12% with the antibody and 8% with placebo, and constipation in 6% versus 2%, respectively. No serious drug-related adverse events were reported, and discontinuations were 3% with the antibody and 4% with placebo. Blood pressure and liver enzymes remained unchanged between groups through week 12.",
    "subclaim": "The antibody was cost-effective.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "Adults with type 2 diabetes were studied.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "Sensitivity for referable diabetic retinopathy was about 0.89.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "Median time to ophthalmology decreased after deployment.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "Unreadable images were automatically referred.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "Children were included in the study.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "The program lowered HbA1c within three months.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "Imaging caused ocular injuries.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "Specificity for referable disease was below 0.50.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "The tool reduced vision loss rates.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "Screening cost per patient decreased.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "The system accurately detected glaucoma.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study across five primary care clinics assessed a smartphone-based fundus camera with on-device AI triage for diabetic retinopathy. Adults with type 2 diabetes were recruited, with a mean age of 57 years; pediatric patients were excluded. Non-mydriatic imaging succeeded in 78% of encounters, and dilation was used when initial images were inadequate. Compared with masked ophthalmologist grading, the AI achieved sensitivity of 0.89 and specificity of 0.82 for referable diabetic retinopathy. For suspected center-involving macular edema, sensitivity was 0.70 using a surrogate marker from images. Unreadable images (7%) triggered automatic referral. After deployment, median time to confirmed ophthalmology appointments fell from 6 weeks to 2 weeks. No ocular adverse events were reported from imaging. The program did not change hemoglobin A1c over 3 months and was not intended to provide treatment; screening completion increased from 62% to 85% over 6 months.",
    "subclaim": "Patient satisfaction improved with the program.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "The trial was double-blind.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "Fluticasone lowered severe exacerbations by about 35%.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "FEV1 rose by roughly 180 mL with active treatment.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "Oral candidiasis was more common with fluticasone.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "Current smokers were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "Blood pressure increased on fluticasone.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "Children under 12 years were included.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "Rescue inhaler use increased with fluticasone.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "The study was industry-funded.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "Baseline mean BMI was 29 kg/m2.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "Weekly home peak flow monitoring was required.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial assessed once-daily inhaled fluticasone furoate versus matched placebo in adults with moderate persistent asthma inadequately controlled on as-needed albuterol. Four hundred thirty participants were enrolled and followed for 24 weeks, with rescue bronchodilators permitted in both arms. The primary endpoint, annualized severe exacerbation rate, was reduced by 35% with fluticasone compared with placebo. Pre-bronchodilator FEV1 improved by a mean of 180 mL in the active-treatment group. Daily rescue inhaler use decreased by 1.2 puffs per day with fluticasone versus 0.3 with placebo. Oral candidiasis occurred in 3.0% on fluticasone and 0.5% on placebo, while rates of headache and dysphonia were similar. No between-group differences were observed in blood pressure or heart rate. Current smokers and patients under 18 years were excluded, and adherence exceeded 85% by dose counter. An exploratory subgroup suggested greater benefit in participants with blood eosinophils ≥300 cells/µL.",
    "subclaim": "FeNO was measured at baseline.",
    "label": "not_supported"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "This was an observational registry study.",
    "label": "supported"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "Apixaban had lower major bleeding than warfarin.",
    "label": "supported"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "Ischemic stroke rates were similar between groups.",
    "label": "supported"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "Warfarin users had a mean TTR of 58%.",
    "label": "supported"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "Dialysis patients were included.",
    "label": "refuted"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "All-cause mortality was higher with apixaban.",
    "label": "refuted"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "Every patient was on amiodarone.",
    "label": "refuted"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "Renal function declined with apixaban.",
    "label": "refuted"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "Apixaban cost less than warfarin.",
    "label": "not_supported"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "CYP2C9 genotyping was used for warfarin dosing.",
    "label": "not_supported"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "Women comprised 60% of the cohort.",
    "label": "not_supported"
  },
  {
    "text": "An observational registry compared outcomes of apixaban versus warfarin in adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients on dialysis were excluded, and dosing followed label recommendations when documented. Over a median of 24 months, apixaban was associated with lower rates of major bleeding than warfarin after multivariable adjustment. Ischemic stroke incidence did not differ significantly between groups. Mean time in therapeutic range for warfarin users was 58%. Concomitant amiodarone was recorded in 12% of the cohort and was linked to higher bleeding risk regardless of anticoagulant. All-cause mortality was similar between groups after adjustment. Serial creatinine values showed stable renal function in both arms.",
    "subclaim": "Mean CHA2DS2-VASc score was 3.5.",
    "label": "not_supported"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "Adults with community-acquired pneumonia were enrolled",
    "label": "supported"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "Procalcitonin guidance reduced antibiotic duration",
    "label": "supported"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "Thirty-day mortality was similar across groups",
    "label": "supported"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "Pregnant patients were excluded",
    "label": "supported"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "The trial enrolled children",
    "label": "refuted"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "Procalcitonin guidance increased ICU admissions",
    "label": "refuted"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "The guided arm had longer antibiotic courses than usual care",
    "label": "refuted"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "C-reactive protein was the biomarker used for guidance",
    "label": "refuted"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "Hospital length of stay was shorter with guidance",
    "label": "not_supported"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "The study was conducted in a single center",
    "label": "not_supported"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "Ninety-day mortality was reduced by guidance",
    "label": "not_supported"
  },
  {
    "text": "In a randomized trial, 420 adults presenting to emergency departments with community-acquired pneumonia were assigned to procalcitonin-guided antibiotic management or usual care. Patients with severe immunosuppression or pregnancy were excluded. The protocol advised withholding or stopping antibiotics when procalcitonin was below 0.25 µg/L or had fallen by at least 80% from baseline, with repeat testing at 24 to 48 hours. Adherence to the algorithm in the guided arm was 78%. Median antibiotic duration was 5 days with guidance versus 8 days with usual care. Thirty-day mortality was similar between groups (3.0% vs 3.5%). Rates of antibiotic-related adverse events were lower in the guided group. ICU admission and early clinical deterioration did not differ between groups.",
    "subclaim": "Clostridioides difficile infections decreased with guidance",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Spironolactone lowered home systolic pressure more than doxazosin",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "The trial used a double-blind crossover design",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Patients with eGFR below 45 were excluded",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Mean heart rate did not change with treatment",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Only single-center patients were enrolled",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Placebo lowered blood pressure more than spironolactone",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Hyperkalemia was absent during spironolactone therapy",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Participants were not taking ACE inhibitors or ARBs",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Spironolactone improved kidney function over 12 weeks",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Office blood pressure reductions exceeded 20 mmHg",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Follow-up continued for one year",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind crossover trial evaluated add-on therapies in 312 adults with resistant hypertension already taking an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide. Participants sequentially received 12 weeks each of spironolactone 25–50 mg daily, doxazosin 4–8 mg daily, and placebo, in random order. Those with an estimated glomerular filtration rate below 45 mL/min/1.73 m² or baseline potassium above 5.0 mmol/L were excluded. Home systolic blood pressure fell the most during spironolactone periods compared with both doxazosin and placebo. Doxazosin produced a modest reduction but was inferior to spironolactone. Mean heart rate did not change meaningfully with any treatment. Hyperkalemia occurred in 3% during spironolactone periods and was managed with dose reduction or withdrawal. Serious adverse events were uncommon and similar across treatments. Effects were consistent across age, sex, and baseline plasma renin strata.",
    "subclaim": "Doxazosin increased hospitalization for heart failure",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "It was a randomized trial.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "Azithromycin was given for 5 days.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "Clinical cure at day 14 was higher with azithromycin.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "Diarrhea was more frequent with amoxicillin-clavulanate.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "Immunocompromised patients were included.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "QT prolongation led to arrhythmia in the azithromycin arm.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "Median hospital stay was longer with azithromycin.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "MRSA bacteremia was common.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "Prior outpatient antibiotic use was an exclusion criterion.",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "The study was industry funded.",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized trial evaluated adults aged 18–65 with mild to moderate community-acquired pneumonia. Participants were assigned to azithromycin for 5 days or amoxicillin-clavulanate for 7 days. Clinical cure at day 14 was 82% with azithromycin and 79% with amoxicillin-clavulanate, meeting non-inferiority. Median hospital stay was 3 days in both arms. Diarrhea occurred in 6% with azithromycin and 15% with amoxicillin-clavulanate. One azithromycin patient had a transient QTc increase without arrhythmia; no torsades or sudden deaths occurred. Immunocompromised and pregnant patients were excluded from enrollment. C-reactive protein declined similarly in both groups, and procalcitonin was recorded but not used to guide therapy. Blood cultures often grew Streptococcus pneumoniae; MRSA was not detected. There was one death in the amoxicillin-clavulanate arm, adjudicated as unrelated to treatment.",
    "subclaim": "Macrolide resistance rates were measured.",
    "label": "not_supported"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "It was a retrospective cohort study.",
    "label": "supported"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "Apixaban had lower major bleeding than warfarin.",
    "label": "supported"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "Ischemic stroke rates were similar between groups.",
    "label": "supported"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "Reduced-dose apixaban was used in most patients.",
    "label": "supported"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "The study was a randomized trial.",
    "label": "refuted"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "Patients on chronic dialysis were included.",
    "label": "refuted"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "Intracranial hemorrhage was more common with apixaban.",
    "label": "refuted"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "All-cause mortality was lower with apixaban.",
    "label": "refuted"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "The median CHA2DS2-VASc score was 5.",
    "label": "not_supported"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "Liver disease was an exclusion criterion.",
    "label": "not_supported"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "Apixaban exposure levels were measured.",
    "label": "not_supported"
  },
  {
    "text": "We performed a retrospective multicenter cohort of patients aged 75 years or older with nonvalvular atrial fibrillation and estimated GFR 25–59 mL/min/1.73 m2 initiating oral anticoagulation. Patients received either apixaban or warfarin at treatment start. The primary outcome, major bleeding at one year, was lower with apixaban (adjusted hazard ratio 0.72, 95% CI 0.58–0.88). Ischemic stroke incidence did not differ significantly between groups (adjusted hazard ratio 0.94, 95% CI 0.73–1.22). Intracranial hemorrhage occurred in 0.6% of apixaban users versus 1.3% of warfarin users. Reduced-dose apixaban (2.5 mg twice daily) was prescribed in 60% of apixaban patients. The mean warfarin time in therapeutic range was 58%. After covariate adjustment, all-cause mortality was similar between groups. Patients on chronic dialysis were excluded, and those with kidney transplants were rare. Concomitant antiplatelet therapy was associated with higher bleeding risk in both cohorts.",
    "subclaim": "Warfarin was managed in an anticoagulation clinic.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "Pregnant patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "For adults over 50, the D-dimer cutoff was age × 10 ng/mL.",
    "label": "supported"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "CT pulmonary angiography use decreased with the age-adjusted strategy.",
    "label": "supported"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "Ninety-day symptomatic VTE after a negative workup did not increase.",
    "label": "supported"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "The study focused on pediatric patients.",
    "label": "refuted"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "Major bleeding was higher with the age-adjusted approach.",
    "label": "refuted"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "A fixed 1000 ng/mL D-dimer threshold was used for all ages.",
    "label": "refuted"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "All-cause mortality increased with the age-adjusted strategy.",
    "label": "refuted"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "Cancer prevalence among participants was reported.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "Ventilation–perfusion scanning use exceeded CT angiography.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "Median D-dimer values were reported.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter prospective study evaluated an age-adjusted D-dimer strategy for ruling out pulmonary embolism in emergency department adults. Investigators used a cutoff of age multiplied by 10 ng/mL for patients older than 50 years, and 500 ng/mL for those 50 or younger. The strategy reduced CT pulmonary angiography use compared with the prior fixed threshold protocol. Rates of 90-day symptomatic venous thromboembolism after a negative workup did not increase. Pregnant patients and those with hemodynamic instability were excluded. Among patients older than 75 years, imaging reductions were most pronounced. Major bleeding and all-cause mortality did not differ between strategies. The study enrolled approximately 1,800 participants across five hospitals.",
    "subclaim": "D-dimer assay turnaround time was reduced.",
    "label": "not_supported"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "Thirty-day readmissions were lower with telemonitoring.",
    "label": "supported"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "Ninety-day mortality did not differ between groups.",
    "label": "supported"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "Patients on chronic dialysis were excluded.",
    "label": "supported"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "Quality of life improved more with the intervention.",
    "label": "supported"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "Only patients with preserved ejection fraction were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "Telemonitoring increased arrhythmia hospitalizations.",
    "label": "refuted"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "Hyperkalemia occurred more often with the intervention.",
    "label": "refuted"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "The mean participant age was 45 years.",
    "label": "refuted"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "Index hospital length of stay was shorter with telemonitoring.",
    "label": "not_supported"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "Emergency department visits at 30 days were reduced by the program.",
    "label": "not_supported"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "NT-proBNP levels fell more in the intervention arm.",
    "label": "not_supported"
  },
  {
    "text": "A randomized controlled trial tested a smartphone-based telemonitoring program for adults with heart failure with reduced ejection fraction after hospital discharge. The intervention consisted of a Bluetooth scale, daily symptom prompts, and nurse-guided diuretic titration via the app. Compared with usual care, the program reduced 30-day all-cause readmissions. Ninety-day mortality was similar between groups. Kansas City Cardiomyopathy Questionnaire scores improved more in the intervention arm at 60 days. There was no significant difference in hospitalizations for arrhythmia. Serum creatinine trajectories and rates of hyperkalemia were comparable. Patients receiving chronic dialysis were excluded. The mean age was 68 years, and median adherence was five reports per week.",
    "subclaim": "The intervention changed beta-blocker dosing.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "Triple therapy reduced COPD exacerbations versus dual therapy.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "Pneumonia was more frequent with triple therapy.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "Mean participant age was 66 years.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "High eosinophils were associated with greater exacerbation reduction.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "Dual therapy produced fewer exacerbations than triple therapy.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "Most participants were current smokers.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "Triple therapy significantly improved quality of life versus dual therapy.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "All-cause mortality was lower with triple therapy.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "Baseline inhaler adherence was electronically monitored.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "Asthma–COPD overlap patients were excluded.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared once-daily triple inhaler therapy (ICS/LABA/LAMA) to dual bronchodilator therapy (LABA/LAMA) in adults with moderate-to-severe COPD. Participants (n=640, mean age 66 years, 45% current smokers) were followed for 48 weeks. The triple regimen reduced the annualized rate of moderate-to-severe exacerbations by 22% versus dual therapy (rate ratio 0.78, 95% CI 0.66–0.92). Pre-bronchodilator FEV1 improved by a mean of 90 mL with triple therapy compared to 20 mL with dual, yielding a between-group difference of 70 mL. Patients with blood eosinophils ≥300 cells/µL had a larger exacerbation reduction than those with lower counts. Rates of pneumonia were higher with triple therapy (7% vs 3%), and oral candidiasis occurred in 5% vs 1%. All-cause mortality and serious cardiovascular events were similar between groups. Quality-of-life scores improved modestly in both arms without a statistically significant between-group difference.",
    "subclaim": "Triple therapy shortened hospital length of stay.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "The trial was double-blind.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "The 5-day regimen had higher clinical failure by day 12–14.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "Diarrhea was more frequent in the 10-day group.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "No serious adverse events occurred.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "Adults were included in the trial.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "Tympanostomy referrals were markedly lower with 10 days.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "The 5-day group had fewer treatment failures than the 10-day group.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "Longer therapy increased penicillin-nonsusceptible pneumococcal carriage.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "The trial took place in three countries.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "High-dose amoxicillin monotherapy was used.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "Prior antibiotic exposure was required for enrollment.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared 5-day versus 10-day amoxicillin–clavulanate for acute otitis media in children. Participants were 6–35 months old; 420 were enrolled across outpatient clinics. The primary outcome, clinical failure by day 12–14, occurred more often with the 5-day regimen (28%) than with 10 days (16%). Recurrent otitis within 30 days was similar between groups (15% vs 14%). Diarrhea was more frequent in the 10-day group (22% vs 15%), while rash occurred at similar rates. No serious adverse events were reported in either arm. Tympanostomy tube referral at 3 months did not differ meaningfully between groups. In a subset, nasopharyngeal carriage of penicillin-nonsusceptible pneumococci did not increase with the longer regimen.",
    "subclaim": "Otoscopic findings were adjudicated by independent reviewers.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "The trial was double-blind and placebo-controlled.",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "Spironolactone lowered systolic blood pressure more than placebo at 12 weeks.",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "Hyperkalemia occurred more often with spironolactone than placebo.",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "Patients with eGFR below 30 mL/min/1.73 m² were excluded.",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "The study was open-label.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "Spironolactone increased systolic blood pressure.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "eGFR improved substantially with spironolactone.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "No hyperkalemia events occurred in the spironolactone arm.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "The trial reduced all-cause mortality.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "Albuminuria decreased with spironolactone.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "All participants had diabetes.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind, placebo-controlled trial evaluated add-on spironolactone in adults with stage 3 chronic kidney disease and resistant hypertension. All participants received an ACE inhibitor or ARB plus a calcium-channel blocker and a thiazide-like diuretic at stable doses. Patients with an eGFR below 30 mL/min/1.73 m² or on dialysis were excluded. Spironolactone 25 mg daily, with optional uptitration to 50 mg, was compared with matched placebo for 12 weeks. At week 12, office systolic blood pressure fell more with spironolactone than with placebo. Mean eGFR changed minimally and did not differ between groups. Serum potassium rose modestly, and hyperkalemia events were more frequent with spironolactone than with placebo. Discontinuations due to adverse events were uncommon and similar between arms.",
    "subclaim": "Diastolic blood pressure fell by 10 mmHg.",
    "label": "not_supported"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "Ultrasound was the first-line test.",
    "label": "supported"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "MRI was used after a non-diagnostic ultrasound.",
    "label": "supported"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "MRI was done without gadolinium.",
    "label": "supported"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "The negative appendectomy rate decreased after the MRI pathway was implemented.",
    "label": "supported"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "Gadolinium contrast was routinely used for MRI.",
    "label": "refuted"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "Ultrasound was avoided as the initial test.",
    "label": "refuted"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "CT was the primary imaging modality.",
    "label": "refuted"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "The negative appendectomy rate increased after the MRI pathway.",
    "label": "refuted"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "The protocol reduced imaging costs.",
    "label": "not_supported"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "Most patients were in the third trimester.",
    "label": "not_supported"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "Perforated appendicitis became less common.",
    "label": "not_supported"
  },
  {
    "text": "An academic center implemented a diagnostic pathway for pregnant patients with suspected appendicitis that used ultrasound first, followed by MRI if ultrasound was non-diagnostic. MRI was performed without gadolinium contrast. In a before-and-after cohort of 180 pregnancies, the negative appendectomy rate fell after the MRI pathway was adopted. Median time to surgery was unchanged between eras. Length of stay was similar as well. Computed tomography was rarely needed, and most cases avoided ionizing radiation. Overnight MRI availability was limited, causing about 6-hour delays in roughly 15% of cases. No fetal losses were attributed to imaging in either period.",
    "subclaim": "General anesthesia was avoided in most surgeries.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "The trial was randomized and multicenter.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "Liraglutazide reduced HbA1c more than sitagliptin.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "Liraglutazide caused greater weight loss than sitagliptin.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "Nausea was more frequent with liraglutazide.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "Only patients older than 75 years were enrolled.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "Sitigliptin produced a larger HbA1c reduction.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "Severe hypoglycemia was common with liraglutazide.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "Patients with prior pancreatitis were included.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "LDL cholesterol decreased with liraglutazide.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "Retinopathy outcomes were reported.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "Medication adherence exceeded 95%.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated, multicenter, randomized, double-blind trial compared once-daily oral liraglutazide 10 mg with sitagliptin 100 mg in adults aged 18–75 years with type 2 diabetes inadequately controlled on metformin. Fourteen sites enrolled 612 participants and followed them for 24 weeks. The primary endpoint was change in HbA1c from baseline. Mean HbA1c fell by 1.2% with liraglutazide and 0.7% with sitagliptin (between-group difference −0.5%, 95% CI −0.7 to −0.3; p<0.001). Body weight decreased by 4.1 kg with liraglutazide and 0.9 kg with sitagliptin. Nausea (21% vs 8%) and diarrhea (12% vs 9%) were the most frequent adverse events with liraglutazide and sitagliptin, respectively. Severe hypoglycemia occurred in 0.3% in each group; mild symptomatic events were 4% vs 3%. Key exclusions were eGFR <30 mL/min/1.73 m2 and any history of pancreatitis.",
    "subclaim": "Cardiovascular events were higher with liraglutazide.",
    "label": "not_supported"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "The study was prospective.",
    "label": "supported"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "The 0/1-hour algorithm ruled out 45% at 1 hour.",
    "label": "supported"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "Sensitivity for index MI was 99.2%.",
    "label": "supported"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "Thirty-day MACE in the rule-out group was 0.3%.",
    "label": "supported"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "The study was retrospective.",
    "label": "refuted"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "Fewer than 10% were ruled out at 1 hour.",
    "label": "refuted"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "Specificity exceeded 90%.",
    "label": "refuted"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "Patients with renal impairment were excluded.",
    "label": "refuted"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "Median symptom-to-presentation time was 12 hours.",
    "label": "not_supported"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "Routine coronary angiography was done in all positives.",
    "label": "not_supported"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "ED length of stay decreased by 2 hours.",
    "label": "not_supported"
  },
  {
    "text": "A prospective diagnostic study evaluated a 0/1-hour high-sensitivity cardiac troponin I algorithm in 1,842 emergency department patients with suspected acute coronary syndrome. Enrollment occurred at three urban hospitals, and clinicians were blinded to study adjudication. The algorithm classified 45% of patients as rule-out at 1 hour. Sensitivity for index myocardial infarction was 99.2% (95% CI 97.6–99.8) with a negative predictive value of 99.7%. Specificity was 62% overall and was lower among patients with reduced eGFR. Adding the HEART score to the algorithm increased specificity to 70% without reducing sensitivity. Thirty-day major adverse cardiac events occurred in 0.3% of the rule-out group. Patients were included regardless of renal function, and a prespecified subgroup analysis examined those with eGFR <60 mL/min/1.73 m2.",
    "subclaim": "Aspirin use at presentation was 80%.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Triple therapy reduced exacerbations vs dual therapy.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Oral candidiasis was more common with triple therapy.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Trough FEV1 gain was larger with triple therapy.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Exacerbation reduction was greater with eosinophils ≥300 cells/µL.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Pneumonia was lower with triple therapy than dual therapy.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Cardiovascular events were fewer with triple therapy.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Only mild COPD patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Exacerbations were more frequent with triple therapy.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Mean age was 65 years.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Patients with asthma were excluded.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Adherence was higher with triple therapy.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial enrolled adults with moderate-to-severe COPD across 42 centers. Participants received either inhaled triple therapy (ICS/LABA/LAMA) or a LABA/LAMA combination for 12 months. The annualized rate of moderate-to-severe exacerbations was 0.82 with triple therapy versus 1.10 with dual therapy (rate ratio 0.75). Trough FEV1 increased by 90 mL from baseline in the triple group and by 40 mL in the dual group. Health-related quality of life improved more with triple therapy, with a mean 4-point reduction in SGRQ versus 2 points with dual. Pneumonia occurred in 4.2% of triple-therapy patients and 4.0% of dual-therapy patients. Oral candidiasis was more frequent with triple therapy (6.1% vs 1.8%). The reduction in exacerbations was greater among patients with blood eosinophils ≥300 cells/µL (rate ratio 0.65), and was consistent across smoking status. Rates of cardiovascular events were similar between groups.",
    "subclaim": "Triple therapy improved 6-minute walk distance.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "POCUS sensitivity for cholecystitis was 88%.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "Radiology ultrasound sensitivity was 92%.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "POCUS reduced time to diagnosis.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "A POCUS-first workflow did not increase negative cholecystectomy.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "POCUS required 30 supervised scans before enrollment.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "Accuracy was worse in high BMI patients.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "POCUS caused serious adverse events.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "The study enrolled only children.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "30-day mortality decreased with POCUS.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "POCUS reduced CT scan use.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "Cost per diagnosis was lower with POCUS.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study of adults with right upper quadrant pain, trained physicians performed point-of-care ultrasound (POCUS) within 30 minutes of triage. A composite reference of surgical pathology or 30-day clinical follow-up defined acute cholecystitis. POCUS showed 88% sensitivity and 82% specificity for the diagnosis. Formal radiology ultrasound had 92% sensitivity and 86% specificity in the same cohort. Use of POCUS reduced time to diagnosis by a median of 78 minutes and advanced antibiotic initiation by 45 minutes. The negative cholecystectomy rate did not increase with a POCUS-first workflow. Diagnostic performance was similar across BMI categories. Operators completed a minimum of 10 supervised scans before enrolling patients. No serious adverse events were attributed to POCUS.",
    "subclaim": "Sensitivity was higher in pregnancy.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "KCCQ score improved more with renfegliflozin than placebo.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "NT-proBNP declined more on renfegliflozin than placebo.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "Heart failure hospitalizations were lower with renfegliflozin.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "Effects were similar in diabetics and non-diabetics.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "Children were enrolled in the trial.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "All-cause mortality at 24 weeks was the primary endpoint.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "Renfegliflozin increased ketoacidosis risk.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "Patients with eGFR below 30 mL/min/1.73 m2 were included.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "Systolic blood pressure fell by 10 mmHg on renfegliflozin.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "Six-minute walk distance improved with renfegliflozin.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "Loop diuretic dose was reduced in the active arm.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 320 adults with symptomatic heart failure with preserved ejection fraction were randomized to renfegliflozin 10 mg daily or placebo on top of standard care. Participants with estimated glomerular filtration rate below 30 mL/min/1.73 m2 were excluded. At 24 weeks, the Kansas City Cardiomyopathy Questionnaire overall summary score increased by 6.8 points with renfegliflozin versus 1.9 points with placebo. NT-proBNP fell by 18% on renfegliflozin compared with 3% on placebo. Heart failure hospitalizations occurred in 10% of patients receiving renfegliflozin and 16% on placebo. Left ventricular ejection fraction did not change meaningfully in either group. Benefits were consistent in patients with and without type 2 diabetes. Genital mycotic infections were more frequent with renfegliflozin, with no excess ketoacidosis or acute kidney injury; the study was funded by a nonprofit foundation.",
    "subclaim": "Renfegliflozin was cost-effective versus placebo.",
    "label": "not_supported"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "Median antibiotic exposure was shorter with procalcitonin guidance.",
    "label": "supported"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "Fourteen-day culture-proven sepsis did not increase with procalcitonin guidance.",
    "label": "supported"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "Thirty-day readmissions were similar between groups.",
    "label": "supported"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "Breastfeeding at discharge did not differ by arm.",
    "label": "supported"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "The trial was single-center.",
    "label": "refuted"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "Only very preterm infants were enrolled.",
    "label": "refuted"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "Procalcitonin guidance led to longer antibiotic treatment.",
    "label": "refuted"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "Sepsis recurrences were higher with procalcitonin guidance.",
    "label": "refuted"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "Length of hospital stay was shorter with procalcitonin guidance.",
    "label": "not_supported"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "C-reactive protein guided therapy in the control arm.",
    "label": "not_supported"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "Blood culture contamination rates were reduced.",
    "label": "not_supported"
  },
  {
    "text": "In a pragmatic trial across five neonatal intensive care units, term and late preterm infants with suspected early-onset sepsis were randomized to a procalcitonin-guided antibiotic protocol or usual care. Exclusion criteria included major congenital anomalies and need for vasopressors. The primary outcome, total antibiotic exposure within the first 7 days of life, was reduced with the procalcitonin algorithm (median 36 hours) compared with usual care (median 60 hours). Rates of culture-proven sepsis or clinical deterioration within 14 days did not increase in the procalcitonin group. Thirty-day readmissions were similar between arms. Adverse events were uncommon and comparable between strategies. Breastfeeding at discharge was unaffected by the protocol. The study spanned 18 months with centralized, blinded outcome adjudication.",
    "subclaim": "Per-patient costs were higher with procalcitonin testing.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "Adults 18–75 were enrolled.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "Combination therapy included rectal budesonide foam.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "Mucosal healing at week 6 was higher with the combination.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "Serious infections were not observed.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "Children under 12 were included.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "Weight gain was common in the combination group.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "CRP fell more with the combination than with monotherapy.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "Hospitalizations were more frequent with combination therapy.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "Therapy adherence exceeded 95%.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "Budesonide foam caused hypertension.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 18 to 75 with moderately active ulcerative colitis experiencing a flare. Participants received either oral mesalamine 2.4 g daily alone or mesalamine plus nightly rectal budesonide foam for six weeks. Clinical remission at week 6, defined by a partial Mayo score ≤2 with no subscore >1, was the primary endpoint. Remission occurred in 54% on combination therapy versus 38% on mesalamine alone (absolute difference 16%; p=0.01). Endoscopic mucosal healing at week 6 was more frequent with the combination (45% vs 30%). C-reactive protein decreased to a similar extent in both groups, but fecal calprotectin fell more with the combination. Systemic corticosteroids were avoided in 82% of patients on combination therapy compared with 70% on monotherapy. Adverse events were mostly mild; headache occurred in 8% vs 6%, transient hyperglycemia in 3% vs 1%, and no serious infections or weight gain were observed. Hospitalizations related to colitis were uncommon and similar between groups (2 vs 3 events) during the study period.",
    "subclaim": "Quality-of-life improved more with the combination.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "A 0/1-hour hs-troponin I algorithm was used.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "ED length of stay decreased after implementation.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "Admission rates fell from 41% to 32%.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "No cardiac deaths occurred at 30 days in the rule-out group.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "Patients with ST-elevation MI were included.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "Aspirin use increased after implementation.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "Women had worse outcomes than men.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "Radiation exposure decreased with the protocol.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "The study was randomized.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "The median patient age was 60 years.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "Point-of-care troponin devices were used.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm with serial ECGs for adults presenting with chest pain without ST-elevation. Over six months, 1,200 patients were evaluated under the protocol. The algorithm classified 59% as rule-out for myocardial infarction, allowing earlier discharge. Median length of stay fell from 6.8 to 4.1 hours compared with the prior 0/3-hour approach. Hospital admission rates declined from 41% to 32% after implementation. Among those ruled out, 30-day major adverse cardiac events occurred in 0.3%, with no cardiac deaths. In patients with estimated glomerular filtration rate below 45 mL/min/1.73 m2, specificity was lower and more cardiology consultations were requested. There was no difference in outcomes by sex, aspirin administration rates were unchanged, and slightly more downstream imaging led to a small increase in radiation exposure.",
    "subclaim": "D-dimer testing was reduced.",
    "label": "not_supported"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "Balanced crystalloids lowered 28-day mortality compared with saline.",
    "label": "supported"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "Chronic dialysis patients were excluded.",
    "label": "supported"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "Renal replacement therapy was less common with balanced fluids.",
    "label": "supported"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "The trial was not blinded.",
    "label": "supported"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "Normal saline reduced 28-day mortality.",
    "label": "refuted"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "Hyperchloremic metabolic acidosis was more frequent with balanced fluids.",
    "label": "refuted"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "Patients on chronic dialysis were included.",
    "label": "refuted"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "The trial was blinded.",
    "label": "refuted"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "Median enrollment lactate was 4 mmol/L.",
    "label": "not_supported"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "Total fluid volume was higher in the balanced arm.",
    "label": "not_supported"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "Ninety-day mortality was reduced.",
    "label": "not_supported"
  },
  {
    "text": "We conducted an open-label, multicenter randomized trial in 14 ICUs, enrolling adults with septic shock within 6 hours of recognition. Patients were assigned to receive balanced crystalloids or 0.9% saline for all resuscitation and maintenance fluids during the first 48 hours; subsequent fluids were per clinician discretion. Pregnant patients and those on chronic dialysis were excluded. Among 612 vs 608 patients, 28-day mortality was lower with balanced fluids (21% vs 26%; adjusted risk ratio 0.80, p=0.04). New acute kidney injury and need for renal replacement therapy were less frequent in the balanced group (14% vs 19% and 8% vs 12%, respectively). Rates of hyperkalemia did not differ between groups, while hyperchloremic metabolic acidosis occurred less often with balanced fluids. Duration of vasopressor use, ventilator-free days, and ICU length of stay were similar. The trial was not blinded.",
    "subclaim": "Arrhythmias were less common with balanced fluids.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "Adults within 3 hours of chest pain were enrolled.",
    "label": "supported"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "The study was not randomized.",
    "label": "supported"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "The microRNA panel had an AUC of 0.89 for type 1 MI.",
    "label": "supported"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "Adding the panel to high-sensitivity troponin increased sensitivity to 99%.",
    "label": "supported"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "Pediatric patients were included.",
    "label": "refuted"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "The test replaced ECG use.",
    "label": "refuted"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "The panel reduced 30-day major adverse cardiac events versus usual care.",
    "label": "refuted"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "It was a randomized trial.",
    "label": "refuted"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "The test cost under 20 USD.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "Specificity at the rule-in threshold was 95%.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "One-year mortality improved.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective multicenter diagnostic accuracy study at three urban emergency departments, we evaluated a five microRNA plasma panel for early detection of type 1 myocardial infarction. Adults aged 25 to 85 presenting within 3 hours of chest pain onset were enrolled; patients with ST-elevation on ECG, pregnancy, or maintenance dialysis were excluded. Blood was sampled at arrival and 1 hour, and testing did not alter standard ECG use. The study was not randomized and served as an adjunct to usual care. The microRNA panel achieved an AUC of 0.89 for adjudicated type 1 MI. At a prespecified rule-out threshold, sensitivity was 96% with specificity of 60%. Combining the panel with high-sensitivity troponin T increased sensitivity to 99% and shortened median time to disposition by 45 minutes. No test-related adverse events occurred, and 30-day major adverse cardiac events were unchanged compared with usual care.",
    "subclaim": "The assay required 10 minutes of centrifugation.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "Adults with moderate COPD were enrolled.",
    "label": "supported"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "The trial was double-blind.",
    "label": "supported"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "Budesonide–formoterol lowered exacerbation rates versus tiotropium.",
    "label": "supported"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "Oral thrush was more frequent with budesonide–formoterol.",
    "label": "supported"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "The study included children.",
    "label": "refuted"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "Tiotropium improved FEV1 more than budesonide–formoterol.",
    "label": "refuted"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "Budesonide–formoterol increased pneumonia risk.",
    "label": "refuted"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "Serious arrhythmias were common.",
    "label": "refuted"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "All-cause mortality decreased with budesonide–formoterol.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "Most participants were current smokers.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "Blood eosinophils predicted treatment response.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a randomized, double-blind trial at two community hospitals in adults with moderate COPD (GOLD II). 220 participants (median age 66 years; 48% women) received either inhaled budesonide–formoterol twice daily or tiotropium once daily for 12 months. The primary outcome was the annualized rate of moderate or severe exacerbations. Budesonide–formoterol reduced exacerbations compared with tiotropium (0.80 vs 1.10 per patient-year; incidence rate ratio 0.73). Prebronchodilator FEV1 increased by a mean of 120 mL at 6 months with budesonide–formoterol and 40 mL with tiotropium. Pneumonia occurred in 3% vs 4%, with no signal for excess risk in the combination group. Oral thrush was more common with budesonide–formoterol (6% vs 1%). Adherence, measured by device counters, was slightly higher with tiotropium. Serious arrhythmias were not observed in either group.",
    "subclaim": "Six-minute walk distance improved by 50 meters.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "A high-sensitivity troponin I 0/1-hour algorithm was evaluated.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "Pregnant patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "Median emergency department stay decreased after implementation.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "Admissions decreased to 17% with the algorithm.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "A troponin T assay was used.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "Point-of-care troponin testing was used.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "Thirty-day MI or cardiac death rose to 3%.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "All patients were admitted after testing.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "Per-visit costs decreased with the algorithm.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "Diabetes altered the algorithm's specificity.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "Nighttime arrivals had longer stays than daytime arrivals.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a high-sensitivity troponin I 0/1-hour algorithm in three urban emergency departments. We enrolled 1,050 adults presenting with possible cardiac chest pain, excluding ST-elevation myocardial infarction, pregnancy, age under 18, and end-stage renal disease on dialysis. Troponin testing used a central laboratory analyzer with results available within 45 minutes. The primary outcomes were emergency department length of stay and 30-day myocardial infarction or cardiac death. After implementation, median length of stay decreased from 8.1 to 5.4 hours. Thirty-day myocardial infarction or cardiac death remained low (0.3% post-implementation vs 0.4% historical control). Unplanned 30-day returns for chest pain did not increase. The proportion admitted fell from 28% to 17% with the algorithm. Costs were not formally assessed in this study.",
    "subclaim": "Coronary CT angiography was routinely performed.",
    "label": "not_supported"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "Adults with type 2 diabetes and stage 3 CKD were enrolled",
    "label": "supported"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "Dapagliflozin slowed eGFR decline versus placebo",
    "label": "supported"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "Heart failure hospitalizations were fewer with dapagliflozin",
    "label": "supported"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "Genital infections were more common with dapagliflozin",
    "label": "supported"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "Only women were enrolled",
    "label": "refuted"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "Follow-up lasted two years",
    "label": "refuted"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "Severe hypoglycemia increased with dapagliflozin",
    "label": "refuted"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "The comparator was insulin therapy",
    "label": "refuted"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "Dapagliflozin reduced stroke events",
    "label": "not_supported"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "Body weight decreased with dapagliflozin",
    "label": "not_supported"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "Albuminuria remission was higher with dapagliflozin",
    "label": "not_supported"
  },
  {
    "text": "A randomized trial evaluated dapagliflozin 10 mg daily versus placebo in adults with type 2 diabetes and stage 3 chronic kidney disease. Four hundred twelve participants were enrolled, 58% men, with a mean age of 64 years. Background renin–angiotensin system blockade was continued in both arms. Over 12 months, the primary endpoint eGFR slope favored dapagliflozin, indicating a slower decline in kidney function. HbA1c decreased modestly with dapagliflozin compared with placebo. Hospitalizations for heart failure were fewer in the dapagliflozin group. Rates of severe hypoglycemia did not differ between groups, but genital infections were more frequent with dapagliflozin. Ketoacidosis was not observed, and adherence exceeded 85% in both arms. The study excluded patients with type 1 diabetes or pregnancy.",
    "subclaim": "The trial was conducted in a single country",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "Outpatients with community-acquired pneumonia were randomized",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "Azithromycin for 5 days was non-inferior for day-14 clinical cure",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "Diarrhea was more frequent with amoxicillin–clavulanate",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "No deaths occurred during follow-up",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "All participants were hospitalized",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "Azithromycin was given for 10 days",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "Ventricular arrhythmias were common with azithromycin",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "Only women were enrolled",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "Time to symptom resolution was shorter with azithromycin",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "Liver enzyme elevations were more common with azithromycin",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "Quality-of-life scores were assessed",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial compared 5 days of azithromycin with 7 days of amoxicillin–clavulanate for outpatient community-acquired pneumonia. Three hundred twenty adults were enrolled, mean age 52 years, and 46% were female. Clinical cure at day 14 met the prespecified noninferiority margin for azithromycin, with rates of 84% versus 82%. Hospitalizations within 30 days were similar between groups. Diarrhea occurred more often with amoxicillin–clavulanate, while nausea rates were comparable. One case of QT prolongation occurred in the azithromycin arm without arrhythmia. Patients with severe hepatic impairment or pregnancy were excluded. Macrolide-resistant Streptococcus pneumoniae was identified in 12% of isolates, yet subgroup cure rates remained comparable. No deaths occurred during follow-up.",
    "subclaim": "Cost-effectiveness favored azithromycin",
    "label": "not_supported"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "The trial compared 5-day azithromycin with 7-day amoxicillin-clavulanate.",
    "label": "supported"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "Azithromycin met noninferiority for day 14 clinical cure.",
    "label": "supported"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "Diarrhea was more common with amoxicillin-clavulanate.",
    "label": "supported"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "Pregnant patients were excluded.",
    "label": "supported"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "Thirty-day mortality was higher with azithromycin.",
    "label": "refuted"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "QT prolongation was more frequent with amoxicillin-clavulanate.",
    "label": "refuted"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "Only non-smokers were enrolled.",
    "label": "refuted"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "Children were included in the study.",
    "label": "refuted"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "Length of hospital stay was shorter with azithromycin.",
    "label": "not_supported"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "Intravenous antibiotics were used in both groups.",
    "label": "not_supported"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "At four urban hospitals, a randomized trial enrolled 612 adults with mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of oral azithromycin or 7 days of amoxicillin-clavulanate. The primary endpoint, clinical cure at day 14, occurred in 82% of azithromycin patients versus 78% of amoxicillin-clavulanate patients, meeting a prespecified noninferiority margin. Diarrhea was more frequent with amoxicillin-clavulanate (15% vs 8%). Transient QT prolongation was observed in 2% on azithromycin and 0.5% on amoxicillin-clavulanate, and no malignant arrhythmias occurred. Thirty-day mortality was 1% in both groups. Exclusion criteria included pregnancy, significant hepatic disease, and macrolide allergy. The cohort had a mean age of 56 years, and 40% were current smokers. Microbiologic testing identified atypical pathogens in 22% of cases.",
    "subclaim": "Culture-guided therapy was required before enrollment.",
    "label": "not_supported"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "A 0/1-hour high-sensitivity troponin algorithm was evaluated.",
    "label": "supported"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "Thirty-day MACE was 0.2% in the rule-out group.",
    "label": "supported"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "Admissions decreased by 18% after implementation.",
    "label": "supported"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "Chronic kidney disease was linked to more false positives.",
    "label": "supported"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "The study included patients with ST-elevation myocardial infarction.",
    "label": "refuted"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "Specificity exceeded 80%.",
    "label": "refuted"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "Women comprised less than 20% of the cohort.",
    "label": "refuted"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "Sensitivity for NSTEMI was under 90%.",
    "label": "refuted"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "Beta-blocker use reduced false positives.",
    "label": "not_supported"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "ECG alone ruled out myocardial infarction in half the patients.",
    "label": "not_supported"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "The median BMI was 27 kg/m2.",
    "label": "not_supported"
  },
  {
    "text": "An observational cohort across three emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm for suspected acute coronary syndrome. Among 1,532 adults without ST-elevation or hemodynamic instability, serial troponins and ECGs were obtained at presentation and one hour. The algorithm achieved 99.2% sensitivity for non-ST-elevation myocardial infarction and 56% specificity. Patients triaged to rule-out had a 30-day major adverse cardiac event rate of 0.2%. Hospital admissions fell by 18% after implementation compared with the prior period. Chronic kidney disease was associated with more false-positive results. The median age was 62 years, and 48% were women. No protocol-related serious adverse events were recorded.",
    "subclaim": "Ninety-day mortality increased after implementation.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "Adults with type 2 diabetes were randomized to semaglutide or glargine.",
    "label": "supported"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "HbA1c reduction at 24 weeks was greater with semaglutide.",
    "label": "supported"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "Weight increased in the glargine group.",
    "label": "supported"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "Hypoglycemia was less frequent with semaglutide.",
    "label": "supported"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "The trial was double-blind.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "Pediatric patients were included.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "Pancreatitis occurred in several participants.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "Kidney function declined in both groups.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "The baseline HbA1c averaged 9.5%.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "Participants were required to use continuous glucose monitors.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "Most enrollees were smokers.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic, open-label randomized trial at five clinics enrolled 312 adults with type 2 diabetes and BMI over 30 kg/m2. Participants were assigned to weekly semaglutide 1 mg or daily insulin glargine, added to stable metformin. The primary endpoint was change in HbA1c at 24 weeks. HbA1c fell by 1.7% with semaglutide and 1.2% with glargine, favoring semaglutide (between-group difference was -0.5%). Weight decreased by 4.8 kg with semaglutide and increased by 1.1 kg with glargine. Symptomatic hypoglycemia occurred in 3% on semaglutide versus 12% on glargine. Nausea was reported in 18% of semaglutide patients, mostly mild and transient. Estimated GFR remained stable in both groups, while microalbuminuria declined in the semaglutide arm. No cases of pancreatitis or diabetic ketoacidosis were observed.",
    "subclaim": "Blood pressure improved with semaglutide.",
    "label": "not_supported"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "The algorithm used 0- and 1-hour high-sensitivity troponin I.",
    "label": "supported"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "Fifty-eight percent were assigned to the rule-out category.",
    "label": "supported"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "Emergency department median length of stay decreased after implementation.",
    "label": "supported"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "Invasive coronary angiography rates did not change.",
    "label": "supported"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "ST-elevation MI patients were included in the pathway.",
    "label": "refuted"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "The study took place at a single rural hospital.",
    "label": "refuted"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "The rule-in group comprised more than half of patients.",
    "label": "refuted"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "Thirty-day MI or cardiac death in rule-out exceeded 2%.",
    "label": "refuted"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "The median age of participants was 64 years.",
    "label": "not_supported"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "Troponin thresholds were adjusted for sex.",
    "label": "not_supported"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "Coronary CT angiography use increased.",
    "label": "not_supported"
  },
  {
    "text": "Two urban emergency departments implemented a 0/1-hour high-sensitivity cardiac troponin I algorithm for adults with suspected acute coronary syndrome and no ST elevation. The prospective cohort included 1,860 patients; dialysis and hemodynamic instability were exclusion criteria. Using predefined cutoffs, 58% were classified as rule-out, 32% as observe, and 10% as rule-in. The primary safety outcome was 30-day myocardial infarction or cardiac death in the rule-out group. This occurred in 0.2% (3 of 1,080), yielding a negative predictive value of 99.8%. Median emergency department length of stay fell from 6.4 to 4.1 hours after implementation. Stress testing utilization decreased from 41% to 28%, while rates of invasive coronary angiography were unchanged. All-cause mortality did not differ across algorithm groups, and no sex-based differences in performance were observed. Patients with ST-elevation myocardial infarction were managed outside the pathway.",
    "subclaim": "The intervention reduced 30-day all-cause mortality.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Dapagliflozin slowed eGFR decline relative to glimepiride.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Hypoglycemia was less frequent with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Genital infections were more common with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Systolic blood pressure fell in the dapagliflozin group.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "The trial enrolled patients with type 1 diabetes.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Glimepiride lowered systolic blood pressure by 4 mmHg.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Heart failure hospitalizations were significantly lower with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "HbA1c reduction was greater with glimepiride than with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Most participants had baseline HbA1c above 9%.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "The study used a double-blind design.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Dapagliflozin increased fracture risk.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 624 adults with type 2 diabetes and stage 3 chronic kidney disease on stable metformin therapy. Participants were assigned to add dapagliflozin 10 mg daily or titrated glimepiride up to 4 mg daily. Over 52 weeks, HbA1c reduction was similar between groups. The annual eGFR decline was slower with dapagliflozin by 2.1 mL/min/1.73 m2 compared with glimepiride. Symptomatic hypoglycemia occurred in 3% with dapagliflozin versus 17% with glimepiride. Genital mycotic infections were more frequent with dapagliflozin (9% vs 2%). Systolic blood pressure decreased by a mean of 4 mmHg with dapagliflozin and did not change with glimepiride. Heart failure hospitalizations were uncommon and not different between groups during follow-up. People with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Participants were predominantly of Asian ancestry.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "Procalcitonin guidance reduced antibiotic days.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "Immunocompromised patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "With procalcitonin <0.1 µg/L, antibiotics were discouraged.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "Thirty-day mortality was similar between groups.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "The trial enrolled children.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "The study was limited to ICU patients.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "Procalcitonin guidance increased antibiotic-related diarrhea.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "Rehospitalization at 30 days was higher with guidance.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "The trial was funded by a diagnostics manufacturer.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "CRP testing was used in both arms.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "Bacterial pneumonia was microbiologically confirmed in most cases.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial across 11 emergency departments tested a procalcitonin-guided algorithm for suspected community-acquired lower respiratory tract infection. Adults without immunocompromise were randomized to procalcitonin guidance or usual care. The algorithm discouraged antibiotics when procalcitonin was below 0.1 µg/L and encouraged treatment when values were higher. Median antibiotic days over 30 days were reduced by 2 days with guidance. Thirty-day mortality and rehospitalization rates were similar between groups. Antibiotic-related adverse events, including diarrhea and rash, were less frequent with guidance. Adherence to the algorithm was 78% among clinicians. The study included both discharged patients and those admitted to general wards, but not ICU-only cohorts.",
    "subclaim": "Procalcitonin was measured with a point-of-care assay.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "Semaglutide lowered HbA1c more than glimepiride.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "Nausea was more common with semaglutide.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "Hypoglycemia was less frequent with semaglutide.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "Systolic blood pressure fell more with semaglutide.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "eGFR declined with semaglutide.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "Retinopathy progression was lower with semaglutide.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "Glimepiride caused greater weight loss than semaglutide.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "More hypoglycemia occurred with semaglutide than glimepiride.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "The study reported cost-effectiveness.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "Baseline HbA1c exceeded 9%.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "Participants were recruited from South America.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 620 adults with type 2 diabetes and eGFR 45–89 mL/min/1.73 m2. Participants received oral semaglutide once daily or glimepiride for 48 weeks. The primary outcome was change in HbA1c. Mean HbA1c fell by 1.5% with semaglutide versus 1.0% with glimepiride (p<0.001). Weight decreased by 3.8 kg with semaglutide and increased by 0.7 kg with glimepiride. Symptomatic hypoglycemia occurred in 4% on semaglutide versus 13% on glimepiride. Nausea was more frequent with semaglutide (18% vs 6%) and was mostly mild and transient. Systolic blood pressure declined by 4 mmHg with semaglutide and 1 mmHg with glimepiride. Estimated GFR remained stable in both groups, and diabetic retinopathy progression did not differ. The trial excluded pregnant individuals and patients with type 1 diabetes.",
    "subclaim": "Semaglutide was given together with metformin.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "A 0/1-hour hs-cTnT algorithm was used.",
    "label": "supported"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "ST-elevation MI cases were excluded.",
    "label": "supported"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "Fifty-four percent were discharged after 1 hour.",
    "label": "supported"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "Chronic kidney disease patients had more false positives.",
    "label": "supported"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "Pediatric patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "The algorithm required a 3-hour second sample.",
    "label": "refuted"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "Rule-in PPV exceeded 90%.",
    "label": "refuted"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "Thirty-day MACE increased after implementation.",
    "label": "refuted"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "Sex-specific troponin thresholds were applied.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "Median emergency department stay was 4 hours.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "The study was conducted in Asia.",
    "label": "not_supported"
  },
  {
    "text": "A prospective study evaluated 1,200 adults presenting to the emergency department with chest pain. A high-sensitivity cardiac troponin T 0/1-hour algorithm was implemented. ST-elevation myocardial infarction was excluded at triage. The rule-out zone achieved 99.7% negative predictive value and 99.2% sensitivity for 30-day myocardial infarction or cardiac death. The rule-in zone positive predictive value was 72%. Fifty-four percent of patients were discharged after the 1-hour blood draw without further testing. Women and men had similar sensitivity in the rule-out zone. Patients with chronic kidney disease showed more false positives in the rule-in zone. Compared with the prior 3-hour protocol, early discharges increased without a rise in 30-day major adverse cardiac events.",
    "subclaim": "Hospital cost savings were reported.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "Participants were 70 years or older.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "Ejection fraction of at least 50% was required.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "Dapagliflozin increased 6-minute walk distance versus placebo.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "Serious adverse event rates were similar between groups.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "The trial was open-label.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "Industry funded the study.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "Heart failure hospitalizations were significantly reduced.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "All-cause mortality was lower with dapagliflozin at 6 months.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "KCCQ quality-of-life scores improved with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "Patients with atrial fibrillation were excluded.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "Most participants had type 2 diabetes.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, 220 adults aged 70 years or older with heart failure with preserved ejection fraction were randomized to dapagliflozin 10 mg daily or placebo for 6 months. Eligibility required left ventricular ejection fraction 50% or higher and estimated GFR at least 30 mL/min/1.73 m^2. The primary outcome, change in 6-minute walk distance, improved by a mean of 28 meters with dapagliflozin versus placebo. NT-proBNP decreased by 18% in the active arm, while no between-group difference was seen in all-cause mortality over 6 months. Heart failure hospitalizations were numerically fewer with dapagliflozin but not statistically different. Rates of serious adverse events were similar, though genital mycotic infections were more common with dapagliflozin. Blood pressure and body weight showed small, non-significant reductions in both groups. The trial was conducted at eight hospitals and funded by an independent grant with no industry involvement.",
    "subclaim": "The study took place in the United States.",
    "label": "not_supported"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "Participants were 6–11 years old.",
    "label": "supported"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "Daily budesonide lowered exacerbation rate versus as-needed albuterol.",
    "label": "supported"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "Growth velocity was slower with budesonide.",
    "label": "supported"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "Serious adverse events were similar between groups.",
    "label": "supported"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "Adults were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "Budesonide increased exacerbations.",
    "label": "refuted"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "The trial lasted 6 weeks.",
    "label": "refuted"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "School absenteeism was lower with budesonide.",
    "label": "refuted"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "Most participants had allergic rhinitis.",
    "label": "not_supported"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "Baseline mean FEV1 was 80% predicted.",
    "label": "not_supported"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "Montelukast use was prohibited.",
    "label": "not_supported"
  },
  {
    "text": "A randomized controlled trial enrolled 360 children aged 6–11 years with persistent mild to moderate asthma. Participants were assigned to daily low-dose budesonide inhalation or as-needed albuterol for 12 months. The primary endpoint was rate of exacerbations requiring oral corticosteroids. Budesonide reduced exacerbations by 35% compared with as-needed albuterol. Pre-bronchodilator FEV1 improved modestly in the budesonide group at 12 months. Growth velocity was 0.8 cm/year lower with budesonide. No differences were seen in serious adverse events or school absenteeism. Adherence averaged 82% with budesonide and 64% in the albuterol group, encouraged by monthly reminders.",
    "subclaim": "Morning cortisol decreased with budesonide.",
    "label": "not_supported"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "The intervention reduced systolic BP more than usual care.",
    "label": "supported"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "62% in the intervention reached SBP under 140 mmHg.",
    "label": "supported"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "Hyperkalemia was more frequent in the intervention arm.",
    "label": "supported"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "Serious adverse events were similar between groups.",
    "label": "supported"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "The trial included only patients over 80 years old.",
    "label": "refuted"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "Beta-blockers were the sole antihypertensive used in the protocol.",
    "label": "refuted"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "Hospitalizations were higher in the intervention group.",
    "label": "refuted"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "Ambulatory blood pressure monitoring was used in all clinics.",
    "label": "refuted"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "The program reduced diastolic pressure variability.",
    "label": "not_supported"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "Black patients benefited less than others.",
    "label": "not_supported"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "Weight loss mediated the blood pressure reduction.",
    "label": "not_supported"
  },
  {
    "text": "A cluster-randomized trial in 24 primary care clinics enrolled adults aged 40–75 with persistently uncontrolled hypertension, baseline office systolic blood pressure 150–170 mmHg. Clinics were assigned to a nurse-led protocol emphasizing home blood pressure monitoring, lifestyle counseling, and lisinopril uptitration, or to usual physician-directed care. At 12 months, mean systolic blood pressure fell by 12 mmHg in the intervention versus 5 mmHg in usual care, a between-group difference of 7 mmHg. Sixty-two percent of intervention patients achieved office systolic pressure under 140 mmHg, compared with 38% in usual care. Adherence to home monitoring reached 78% in the protocol arm and 20% in usual care, aided by automated text reminders. Hyperkalemia occurred in 3% of intervention patients and 1% of controls, while serious adverse events and hospitalizations were similar between groups. The blood pressure benefit was consistent in the prespecified subgroup with stage 3 chronic kidney disease. No clinic used ambulatory blood pressure monitoring for outcome assessment.",
    "subclaim": "The protocol improved statin adherence.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Tenecteplase had shorter door-to-needle time than alteplase.",
    "label": "supported"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Symptomatic intracranial hemorrhage rates were similar between agents.",
    "label": "supported"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Early reperfusion before thrombectomy was more frequent with tenecteplase.",
    "label": "supported"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Pregnant patients were excluded from the registry.",
    "label": "supported"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Tenecteplase significantly improved functional independence at 90 days.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Ninety-day mortality with tenecteplase exceeded 20%.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Most enrolled patients were older than 90 years.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Warfarin users were included regardless of INR value.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Women had better outcomes with tenecteplase than men.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Prehospital stroke scales were used to select patients.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Tenecteplase reduced hospital costs per patient.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter registry, adults aged 18–90 with acute ischemic stroke treated within 4.5 hours received either tenecteplase 0.25 mg/kg or alteplase 0.9 mg/kg per local protocol. Pregnant patients were excluded, and those on warfarin were treated only if the INR was 1.7 or lower. The primary outcome was functional independence (modified Rankin Scale 0–2) at 90 days. Functional independence occurred in 52% of tenecteplase patients and 48% of alteplase patients, yielding an adjusted odds ratio of 1.18 with p=0.08. Median door-to-needle time was shorter with tenecteplase, 28 minutes versus 39 minutes for alteplase. Symptomatic intracranial hemorrhage occurred in 3.2% with tenecteplase and 3.5% with alteplase. Among patients with large-vessel occlusion who proceeded to thrombectomy, early reperfusion before groin puncture was more frequent after tenecteplase, 22% versus 12%. Ninety-day mortality was similar between groups at 12% with tenecteplase and 13% with alteplase. Rates of post-stroke pneumonia did not differ.",
    "subclaim": "Door-in-door-out transfer rates differed between groups.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "Dialysis patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "The protocol reduced hospital admissions.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "ED length of stay was shorter with the algorithm.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "No sex-based safety differences were seen.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "Pediatric patients were included.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "The algorithm increased missed myocardial infarction.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "All patients underwent mandatory invasive angiography.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "A high-sensitivity troponin I assay was used.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "The median age was 72 years.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "The HEART score was required for triage.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "The protocol reduced healthcare costs.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter trial assessed a 0/1-hour high-sensitivity cardiac troponin T algorithm for adults presenting to the emergency department with chest pain. Patients on dialysis were excluded, and 2,140 participants were enrolled across five hospitals. The algorithm ruled out myocardial infarction if baseline troponin T was below 5 ng/L with a 1-hour delta under 3 ng/L. Compared with standard 3-hour testing, the protocol reduced admissions from 62% to 48% and shortened median ED stay from 7.1 to 4.3 hours. The rate of missed myocardial infarction within 30 days did not increase (0.3% vs 0.4%), and all-cause 30-day mortality was similar between groups. No sex-based differences in safety were observed. In patients with estimated GFR under 60 mL/min/1.73 m², more individuals were classified as rule-in, yet the negative predictive value remained above 99%. Use of invasive angiography during the index visit was at clinician discretion and not mandated.",
    "subclaim": "Thirty-day unplanned revascularization decreased.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "The trial compared 5 versus 10 days of cephalexin.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "Clinical cure met the noninferiority margin.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "Adverse events were fewer with 5 days.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "Immunocompromised patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "Children were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "All therapy was intravenous.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "The 10-day group had higher cure than the 5-day group.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "The 5-day arm had more adverse events.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "Cephalexin dose was 500 mg four times daily.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "Median BMI was 31 kg/m².",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "MRSA colonization was common.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial compared 5-day versus 10-day oral cephalexin for uncomplicated nonpurulent cellulitis in adults. Immunocompromised individuals and diabetic foot infections were excluded. All participants received identical dosing and were re-evaluated at day 3 to confirm clinical improvement before continuing assigned duration. The primary endpoint was clinical cure at day 14 with a 10% noninferiority margin. Cure occurred in 85% of the 5-day group and 83% of the 10-day group, meeting noninferiority. Adverse events, primarily gastrointestinal upset and rash, were less frequent with 5 days of therapy. Thirty-day recurrence and need for rescue antibiotics were similar between groups. No cases of Clostridioides difficile infection were detected.",
    "subclaim": "Shorter therapy reduced outpatient costs.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "Adults with type 2 diabetes were enrolled",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "Empagliflozin slowed eGFR decline versus placebo",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "Heart failure hospitalizations were reduced with empagliflozin",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "Genital mycotic infections were more common with empagliflozin",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "The study enrolled patients with type 1 diabetes",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "Diabetic ketoacidosis was higher with empagliflozin",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "All participants had eGFR above 90 mL/min/1.73 m2",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "Retinopathy progression was lower with empagliflozin",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "The trial was funded by the drug manufacturer",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "Mean baseline BMI exceeded 35 kg/m2",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "GLP-1 receptor agonists were prohibited",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–60 mL/min/1.73 m2) with albuminuria. Participants received empagliflozin 10 mg daily or placebo on top of ACE inhibitor or ARB therapy. Over 18 months, empagliflozin slowed the annual eGFR decline compared with placebo and reduced hospitalizations for heart failure. HbA1c fell modestly in the empagliflozin group, without excess severe hypoglycemia. Rates of diabetic ketoacidosis did not differ between groups. Mild genital mycotic infections were more frequent with empagliflozin, but amputations were not increased. Retinopathy progression rates were similar in both arms. Sites were located in Europe and Asia, and type 1 diabetes was excluded.",
    "subclaim": "North American sites enrolled most participants",
    "label": "not_supported"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "Chest X-ray determined use of V/Q versus CTPA",
    "label": "supported"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "D-dimer was not used to guide testing",
    "label": "supported"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "Three-month VTE rates were low after a negative workup",
    "label": "supported"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "Hemodynamically unstable patients were excluded",
    "label": "supported"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "Non-pregnant adults were included in the cohort",
    "label": "refuted"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "V/Q scans delivered higher breast radiation than CT",
    "label": "refuted"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "Contrast reactions were common",
    "label": "refuted"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "All patients received empirical anticoagulation before imaging",
    "label": "refuted"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "Median gestational age at presentation was 30 weeks",
    "label": "not_supported"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "Breastfeeding was interrupted after imaging",
    "label": "not_supported"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "Long-term child neurodevelopment was assessed",
    "label": "not_supported"
  },
  {
    "text": "In a prospective cohort of pregnant patients with suspected pulmonary embolism, clinicians used a structured imaging algorithm. A chest radiograph was obtained first; if normal, ventilation–perfusion scanning was performed, otherwise CT pulmonary angiography was chosen. D-dimer was not used to guide testing due to poor specificity in pregnancy. Bilateral leg ultrasound was added when clinical signs of deep vein thrombosis were present. Anticoagulation was deferred until imaging results were available, and withheld when studies were negative. Radiation exposure to the maternal breast was lower with the ventilation–perfusion strategy than with CT. No contrast reactions occurred, and there were no major bleeding events. Three-month venous thromboembolism rates after negative workups were very low. Hemodynamically unstable patients were excluded from the study.",
    "subclaim": "A low-dose CTPA protocol with tin filtration was used",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "CT perfusion guided patient selection.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Door-to-needle time was shorter with tenecteplase.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Symptomatic intracranial hemorrhage was 3% with tenecteplase and 5% with alteplase.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Ninety-day mortality was 15% in both arms.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Children under 18 were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Tenecteplase was dosed at 0.9 mg/kg.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Alteplase achieved more mRS 0–1 than tenecteplase.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Patients on therapeutic anticoagulation were eligible.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Twenty percent underwent mechanical thrombectomy.",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Median baseline NIHSS score was 8.",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Oropharyngeal angioedema was more frequent with alteplase.",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized trial compared intravenous tenecteplase 0.25 mg/kg with alteplase 0.9 mg/kg for adults presenting with acute ischemic stroke within 4.5 hours of onset. Patient selection used non-contrast head CT and CT perfusion to confirm salvageable tissue. Door-to-needle time was shorter with tenecteplase (median 28 minutes) than with alteplase (median 37 minutes). At 90 days, the proportion achieving modified Rankin Scale 0–1 was 42% with tenecteplase and 35% with alteplase. Symptomatic intracranial hemorrhage occurred in 3% on tenecteplase versus 5% on alteplase. All-cause mortality at 90 days was identical at 15% in both arms. Patients younger than 18 years and those on therapeutic anticoagulation were excluded. No difference in early neurological deterioration within 24 hours was observed between groups.",
    "subclaim": "Door-to-imaging time averaged 15 minutes.",
    "label": "not_supported"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "A pharmacist-led stewardship team was part of the intervention.",
    "label": "supported"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "Rapid PCR reduced time to appropriate therapy from 25 h to 7 h.",
    "label": "supported"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "Thirty-day mortality was 10% in both groups.",
    "label": "supported"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "Severe neutropenia was an exclusion criterion.",
    "label": "supported"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "Children were included.",
    "label": "refuted"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "Length of stay was longer with the PCR panel.",
    "label": "refuted"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "C. difficile infection increased with the intervention.",
    "label": "refuted"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "The intervention lacked antimicrobial stewardship.",
    "label": "refuted"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "Per-patient hospital costs decreased by $500.",
    "label": "not_supported"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "Vancomycin therapeutic drug monitoring was more frequent in the intervention arm.",
    "label": "not_supported"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "Carbapenem consumption decreased by 15%.",
    "label": "not_supported"
  },
  {
    "text": "A two-hospital prospective cohort evaluated a rapid multiplex PCR blood culture identification panel combined with pharmacist-led antimicrobial stewardship for adults with their first positive inpatient blood culture. Compared with standard microbiology workflow, the intervention reduced median time to appropriate therapy from 25 hours to 7 hours. Hospital length of stay was one day shorter in the PCR group (median 6 vs 7 days). Thirty-day all-cause mortality was 10% in both groups. Rates of Clostridioides difficile infection during admission were 2% in each arm. Pediatric patients and those with severe neutropenia were excluded. The proportion of methicillin-resistant Staphylococcus aureus bacteremia was similar between groups. No difference in ICU transfer after culture positivity was detected.",
    "subclaim": "Time to blood culture positivity was shorter with PCR.",
    "label": "not_supported"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Dapagliflozin lowered heart failure hospitalizations.",
    "label": "supported"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Genital mycotic infections were more common with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "KCCQ scores improved at 8 weeks with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Benefit was seen both with and without diabetes.",
    "label": "supported"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Patients with eGFR below 20 mL/min/1.73 m2 were enrolled.",
    "label": "refuted"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Dapagliflozin significantly increased LVEF.",
    "label": "refuted"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Systolic blood pressure rose by about 10 mm Hg with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Acute kidney injury was more frequent with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Dapagliflozin reduced all-cause mortality.",
    "label": "not_supported"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Loop diuretic doses were reduced in the dapagliflozin arm.",
    "label": "not_supported"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Six-minute walk distance increased with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "An international, double-blind trial enrolled 4,800 adults with symptomatic heart failure with reduced ejection fraction (LVEF ≤40%). Participants (mean age 68 years, 40% women) were randomized to dapagliflozin 10 mg daily or placebo on top of guideline-directed therapy. Patients with estimated glomerular filtration rate below 30 mL/min/1.73 m^2 were excluded. Over a median follow-up of 14 months, dapagliflozin reduced the rate of heart failure hospitalization by 25% compared with placebo. Kansas City Cardiomyopathy Questionnaire overall summary scores improved by a mean of 4 points at 8 weeks with dapagliflozin. Left ventricular ejection fraction did not change significantly between groups. Rates of symptomatic hypotension and acute kidney injury were similar, while genital mycotic infections were more frequent with dapagliflozin. Benefits were consistent in participants with and without type 2 diabetes. Mean systolic blood pressure decreased modestly by about 3 mm Hg in the dapagliflozin arm.",
    "subclaim": "Twenty percent of participants were of African ancestry.",
    "label": "not_supported"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "Procalcitonin guidance reduced antibiotic days.",
    "label": "supported"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "ICU length of stay was similar between groups.",
    "label": "supported"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "Twenty-eight–day mortality was noninferior.",
    "label": "supported"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "C. difficile infections were fewer with procalcitonin guidance.",
    "label": "supported"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "Neutropenic patients were included in the trial.",
    "label": "refuted"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "The algorithm stopped antibiotics only when procalcitonin was above 2 µg/L.",
    "label": "refuted"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "Mechanical ventilation duration was shorter with procalcitonin guidance.",
    "label": "refuted"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "Acute kidney injury was higher in the procalcitonin arm.",
    "label": "refuted"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "Ninety-day mortality was reduced.",
    "label": "not_supported"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "The intervention lowered hospital costs.",
    "label": "not_supported"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "Pediatric ICUs were studied.",
    "label": "not_supported"
  },
  {
    "text": "Adults admitted to 12 ICUs with suspected bacterial sepsis were randomized in a pragmatic, open-label trial to procalcitonin-guided antibiotic management or usual care. The algorithm advised stopping antibiotics when procalcitonin fell to less than 0.5 µg/L or decreased by at least 80% from peak. Neutropenic patients and those on chronic dialysis were excluded. Among 902 participants (median age 61 years), the procalcitonin group had 2.1 fewer antibiotic days within 28 days than usual care. ICU length of stay and days on mechanical ventilation were similar between groups. Twenty-eight–day mortality met a predefined noninferiority margin. Clostridioides difficile infections occurred less often in the procalcitonin arm. Rates of acute kidney injury did not differ. In a prespecified respiratory-source subgroup, antibiotic exposure decreased the most with procalcitonin guidance.",
    "subclaim": "Viral pathogen detection improved with the strategy.",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "IV iron increased hemoglobin more than oral therapy at 8 weeks.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "Week-8 ferritin was higher with IV ferric carboxymaltose.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "GI adverse events were less frequent with IV iron than oral ferrous sulfate.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "No anaphylaxis occurred in either study arm.",
    "label": "supported"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "Pregnant women were included.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "The study duration was 6 months.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "Chronic kidney disease patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "Blood transfusions were administered during the trial.",
    "label": "refuted"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "IV iron reduced hospital admissions.",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "Ferric carboxymaltose improved fatigue more than oral iron.",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "Treatment reduced menstrual blood loss.",
    "label": "not_supported"
  },
  {
    "text": "A single-center randomized open-label trial enrolled 180 nonpregnant women aged 18–50 with iron deficiency anemia due to heavy menstrual bleeding. Participants received either intravenous ferric carboxymaltose as two infusions over 2 weeks or oral ferrous sulfate 325 mg twice daily for 8 weeks. The primary endpoint was hemoglobin change at week 8; secondary endpoints included week-8 ferritin, time to hemoglobin ≥12 g/dL, gastrointestinal adverse events, and hypophosphatemia. The IV group had a greater mean hemoglobin increase at week 8 and more often achieved hemoglobin ≥12 g/dL by week 4 than the oral group. Ferritin at week 8 was markedly higher with IV therapy. Gastrointestinal adverse events such as constipation and nausea were less frequent in the IV arm. Transient asymptomatic hypophosphatemia occurred in 9% of IV recipients, and no anaphylactic reactions occurred in either arm. Patients with chronic kidney disease were excluded, and no blood transfusions were given during the study. The trial was not powered to assess recurrence of anemia beyond 8 weeks.",
    "subclaim": "IV therapy was more cost-effective than oral therapy.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "Procalcitonin guidance reduced antibiotic exposure.",
    "label": "supported"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "Thirty-day mortality was similar between groups.",
    "label": "supported"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "Clinicians overrode the algorithm in about 20% of cases.",
    "label": "supported"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "Immunocompromised patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "Antibiotics were recommended when procalcitonin was below 0.25 ng/mL.",
    "label": "refuted"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "ICU admissions were higher with procalcitonin guidance.",
    "label": "refuted"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "Pregnant individuals were included in the trial.",
    "label": "refuted"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "Procalcitonin guidance increased antibiotic days.",
    "label": "refuted"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "Hospital length of stay was shorter with procalcitonin guidance.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "The trial demonstrated cost savings.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "Viral PCR testing was mandatory for enrollment.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter pragmatic trial across 12 emergency departments enrolled 1,140 adults with suspected lower respiratory tract infection. Patients were randomized to procalcitonin-guided antibiotic management or usual care. The algorithm advised withholding antibiotics when procalcitonin was below 0.25 ng/mL and stopping therapy when values dropped by at least 80% from baseline. Median antibiotic exposure over 30 days was shorter with procalcitonin guidance than with usual care. Thirty-day mortality and ICU admissions did not differ between groups. Treating clinicians overrode the algorithm in approximately 20% of encounters. Immunocompromised patients, pregnant individuals, and those in septic shock were excluded. Adverse events, including Clostridioides difficile infection and rash, were uncommon and similar between groups. The study was not designed to assess cost-effectiveness or long-term resistance trends.",
    "subclaim": "Antibiotic resistance rates declined over 12 months.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "Adults with mild persistent asthma were enrolled.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "Budesonide-formoterol reduced exacerbations by 35% versus albuterol.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "FEV1 at week 12 showed no significant difference between groups.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "Adherence was similar in both treatment arms.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "Children were included in the trial.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "The trial lasted six months.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "Resting heart rate increased with budesonide-formoterol.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "Current smokers were allowed to enroll.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "Nighttime symptom scores improved more with budesonide-formoterol.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "Blood eosinophil counts decreased during treatment.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "Emergency department visits after week 12 were reduced.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 312 adults aged 18 to 65 with mild persistent asthma. Participants were assigned to as-needed budesonide-formoterol or as-needed albuterol for 12 weeks. Rates of moderate or severe exacerbations were 35% lower with budesonide-formoterol than with albuterol (rate ratio 0.65, 95% CI 0.48 to 0.88). Pre-bronchodilator FEV1 at week 12 did not differ significantly between groups. Self-reported adherence and canister weights were similar in both arms. Resting heart rate and blood pressure remained unchanged from baseline in either group. Tremor was more common in the albuterol group, while oral candidiasis was rare in both. Current smokers and children were excluded from enrollment.",
    "subclaim": "The study reported cost-effectiveness results.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "Adults with chest pain were studied.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "The 0/2-hour hs-troponin I algorithm had an NPV of 99.4%.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "Specificity was lower in chronic kidney disease while NPV stayed above 99%.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "No thrombolysis was given in the study.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "Children were enrolled in the study.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "The algorithm required overnight hospitalization for rule-out.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "Point-of-care ultrasound outperformed the ECG for diagnosing MI.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "Aspirin use was mandated by the protocol.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "Women had higher MI rates than men.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "The study reported cost savings from early discharge.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "Sensitivity of the algorithm exceeded 99.9%.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study, 430 adults with acute chest pain underwent a 0/2-hour high-sensitivity troponin I algorithm and standard ECG. Median age was 62 years, and 27 patients met adjudicated myocardial infarction criteria. The algorithm ruled out MI within two hours with a negative predictive value of 99.4% (95% CI 97.8 to 99.9). Specificity was lower among patients with chronic kidney disease, but negative predictive value in that subgroup remained above 99%. Point-of-care cardiac ultrasound showed limited incremental value and did not outperform the ECG for identifying MI. No thrombolytic therapy was administered as part of the study protocol. Thirty-day major adverse cardiac events were tracked, with no deaths among those ruled out by the algorithm. Enrollment excluded patients younger than 18 years. Use of aspirin before arrival was recorded but not mandated.",
    "subclaim": "All patients were discharged on dual antiplatelet therapy.",
    "label": "not_supported"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Adults aged 55–85 were enrolled.",
    "label": "supported"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Dapagliflozin reduced heart failure hospitalizations.",
    "label": "supported"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Genital mycotic infections were more common with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "All-cause mortality did not differ between groups.",
    "label": "supported"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Patients with type 1 diabetes were included.",
    "label": "refuted"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Baseline eGFR below 30 was allowed.",
    "label": "refuted"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Systolic blood pressure increased with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Diabetic ketoacidosis was more frequent with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Mean body weight decreased by 2 kg with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Left ventricular ejection fraction improved by 10% with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Black participants comprised 40% of the cohort.",
    "label": "not_supported"
  },
  {
    "text": "This randomized, double-blind trial enrolled 420 adults aged 55–85 with heart failure with reduced ejection fraction (LVEF ≤35%). Participants received dapagliflozin 10 mg daily or placebo in addition to guideline-directed therapy for 12 months. The primary endpoint, heart failure hospitalization, was reduced by 28% with dapagliflozin versus placebo. NT-proBNP fell more with dapagliflozin (median −18% vs −5%). Systolic blood pressure declined modestly by 3 mmHg without symptomatic hypotension. Serum potassium remained stable, and eGFR showed a small early dip then stabilization, with no overall renal deterioration versus placebo. No diabetic ketoacidosis occurred; genital mycotic infections were more frequent with dapagliflozin (6% vs 2%). All-cause mortality was similar between groups. Key exclusions were type 1 diabetes and baseline eGFR <30 mL/min/1.73 m².",
    "subclaim": "Medication adherence exceeded 95%.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "Dialysis patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "Fifty-eight percent were classified as rule-out and discharged.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "The algorithm reduced emergency department length of stay.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "Sensitivity was preserved in patients over 75 years.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "ST-elevation MI patients were included.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "Thirty-day MACE among rule-out patients was 5%.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "The algorithm increased 30-day mortality.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "Most rule-out patients needed imaging.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "The study was conducted in Asia.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "Median age was 62 years.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "Per-patient costs decreased by $200.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter emergency department study enrolled 1,800 adults presenting with chest pain. Clinicians applied a high-sensitivity troponin I 0/1-hour algorithm alongside ECG interpretation. Patients on dialysis and those with ST-elevation myocardial infarction at presentation were excluded. Overall, 58% were classified as rule-out and discharged the same day. Among rule-out patients, 30-day major adverse cardiac events occurred in 0.3% (5 cases), with sensitivity for index myocardial infarction of 99.4% and negative predictive value of 99.7%. Fourteen percent were rule-in, with the remainder observed. Implementation reduced median emergency department length of stay by 2.1 hours compared with a historical cohort, without an increase in 30-day mortality. In patients older than 75 years, specificity was lower but sensitivity was preserved. No sex-based safety differences were seen, and most rule-out cases did not require imaging.",
    "subclaim": "Coronary CT angiography was the default imaging modality.",
    "label": "not_supported"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "The trial randomized adults with OSA to semaglutide or placebo.",
    "label": "supported"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "AHI decreased more with semaglutide than with placebo at 24 weeks.",
    "label": "supported"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "Participants lost more weight on semaglutide.",
    "label": "supported"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "Nausea was more frequent with semaglutide.",
    "label": "supported"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "Adolescents were enrolled in the trial.",
    "label": "refuted"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "All participants were required to use CPAP.",
    "label": "refuted"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "Systolic blood pressure improved significantly with semaglutide.",
    "label": "refuted"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "At least one pancreatitis case occurred on semaglutide.",
    "label": "refuted"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "One-year relapse rates were reported.",
    "label": "not_supported"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "HbA1c change was reported.",
    "label": "not_supported"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "LDL cholesterol decreased with semaglutide.",
    "label": "not_supported"
  },
  {
    "text": "The SOMNIA trial randomized 180 adults aged 30 to 70 with moderate-to-severe obstructive sleep apnea and BMI at least 35 to weekly semaglutide 2.4 mg or placebo. Participants were not using CPAP and were recruited from six sleep clinics. The primary endpoint was change in apnea-hypopnea index at 24 weeks, with secondary endpoints including body weight, daytime sleepiness, and blood pressure. Mean apnea-hypopnea index fell by 9.1 events per hour with semaglutide versus 2.3 with placebo, a between-group difference of -6.8 (p<0.001). Body weight decreased by 8.5% with semaglutide compared with 1.2% with placebo. Epworth Sleepiness Scale scores improved by 3.0 points on semaglutide and 1.1 on placebo. Systolic blood pressure did not change significantly in either group. Nausea was reported in 18% on semaglutide versus 6% on placebo, and no pancreatitis cases occurred. Treatment discontinuation occurred in 7% and 5% of participants in the semaglutide and placebo arms, respectively. The trial was double-blind and powered for the primary endpoint.",
    "subclaim": "Driving crash risk was assessed.",
    "label": "not_supported"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "A 0/1-hour hs-cTnT algorithm was evaluated.",
    "label": "supported"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "Emergency department length of stay decreased after implementation.",
    "label": "supported"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "Hospital admissions fell after implementation.",
    "label": "supported"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "Return ED visit rates were unchanged within 7 days.",
    "label": "supported"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "Thirty-day mortality increased after implementation.",
    "label": "refuted"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "Patients with ST-elevation myocardial infarction were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "Sensitivity for index myocardial infarction declined post-implementation.",
    "label": "refuted"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "The algorithm used high-sensitivity troponin I rather than troponin T.",
    "label": "refuted"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "Per-patient costs decreased.",
    "label": "not_supported"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "Stress testing orders decreased.",
    "label": "not_supported"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "Cardiology consults decreased.",
    "label": "not_supported"
  },
  {
    "text": "A prospective, stepped-wedge study across four urban emergency departments evaluated a 0/1-hour high-sensitivity troponin T algorithm for suspected acute coronary syndrome. Adults presenting with chest pain and no ST-elevation were included, while dialysis and pregnant patients were excluded. The algorithm combined high-sensitivity troponin T at presentation and 1 hour with ECG assessment and clinical risk. After implementation, median emergency department length of stay decreased from 6.1 to 4.2 hours. Hospital admissions fell from 52% to 38% without an increase in 30-day mortality. Among patients discharged using the algorithm, 30-day myocardial infarction or cardiac death occurred in 0.3%, non-inferior to the 0.4% rate before implementation. Sensitivity for index myocardial infarction was 99.3% post-implementation versus 97.8% with the prior 3-hour protocol. Rates of return emergency department visits within 7 days were unchanged at 6% in both periods. No sex-based difference in safety was observed on prespecified subgroup analysis.",
    "subclaim": "Patient satisfaction improved.",
    "label": "not_supported"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "SMART reduced severe exacerbations vs usual care.",
    "label": "supported"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "FEV1 gain was greater with SMART.",
    "label": "supported"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "Rescue inhaler use was lower with SMART.",
    "label": "supported"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "Oral candidiasis was less frequent with SMART.",
    "label": "supported"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "Hospitalizations were higher with SMART.",
    "label": "refuted"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "Adherence was worse with SMART.",
    "label": "refuted"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "Children under 10 were included.",
    "label": "refuted"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "New safety signals were detected.",
    "label": "refuted"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "SMART lowered total healthcare costs.",
    "label": "not_supported"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "Most participants were male.",
    "label": "not_supported"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "Exhaled nitric oxide decreased with SMART.",
    "label": "not_supported"
  },
  {
    "text": "At three urban clinics, a 24-week randomized trial enrolled 312 adolescents aged 12–17 with moderate persistent asthma. Participants received either SMART therapy using budesonide-formoterol for both maintenance and relief, or usual care with twice-daily fluticasone plus as-needed albuterol. The SMART group had fewer severe exacerbations requiring oral corticosteroids (0.60 vs 0.90 per patient; rate ratio 0.67). FEV1 improved more with SMART (+150 mL vs +60 mL). Mean days with rescue inhaler use per week declined in the SMART arm (1.2 vs 2.1). Hospitalization rates were low and similar between groups (3% SMART vs 4% usual care). Reported adherence did not differ meaningfully between groups. Oral candidiasis occurred less often with SMART (2% vs 5%), and no new safety signals emerged. Baseline allergic rhinitis was present in 20% across both arms.",
    "subclaim": "Montelukast was part of usual care.",
    "label": "not_supported"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "The POCUS-first pathway shortened time to decision.",
    "label": "supported"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "POCUS sensitivity was 88%.",
    "label": "supported"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "Negative appendectomy did not increase with POCUS-first.",
    "label": "supported"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "Radiation exposure was lower with POCUS-first.",
    "label": "supported"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "Perforation rates were higher with POCUS-first.",
    "label": "refuted"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "Only pediatric patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "POCUS operators had 20 hours of training.",
    "label": "refuted"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "CT was never used in the POCUS-first arm.",
    "label": "refuted"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "The pathway reduced costs of care.",
    "label": "not_supported"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "Incidental CT findings decreased.",
    "label": "not_supported"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "Patient satisfaction improved.",
    "label": "not_supported"
  },
  {
    "text": "An emergency department study at two urban hospitals evaluated a POCUS-first pathway for suspected adult appendicitis. Over 14 months, 486 patients were alternately assigned to POCUS as the initial test with selective confirmatory CT, or to immediate CT. Median time to diagnostic decision was shorter with POCUS-first (2.1 vs 3.6 hours). Sensitivity and specificity of POCUS for appendicitis were 88% and 92%, respectively, when compared to final adjudicated diagnosis. The rate of negative appendectomy did not increase with POCUS-first (5% vs 6%). Cumulative radiation exposure per patient was lower in the POCUS-first group. Perforation rates at surgery were similar between pathways. Emergency physicians completed a focused 4-hour training before the study. No pregnancies were included.",
    "subclaim": "Ultrasound gel allergies occurred.",
    "label": "not_supported"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "The trial was double-blind.",
    "label": "supported"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "Participants had stage 3 chronic kidney disease.",
    "label": "supported"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "Apixaban reduced major bleeding versus warfarin.",
    "label": "supported"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "All-cause mortality was similar between groups.",
    "label": "supported"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "The study included patients with eGFR below 30 mL/min/1.73 m^2.",
    "label": "refuted"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "Warfarin had fewer strokes than apixaban.",
    "label": "refuted"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "The warfarin time in therapeutic range averaged under 40%.",
    "label": "refuted"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "The trial was open-label.",
    "label": "refuted"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "Quality of life was assessed.",
    "label": "not_supported"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "Concomitant antiplatelet use was prohibited.",
    "label": "not_supported"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "The benefit persisted beyond 24 months.",
    "label": "not_supported"
  },
  {
    "text": "At 22 hospitals, a double-blind, double-dummy trial enrolled 640 adults with nonvalvular atrial fibrillation and stage 3 chronic kidney disease. Patients were randomized to apixaban 5 mg twice daily or dose-adjusted warfarin. The primary endpoint was stroke or systemic embolism at 12 months, and major bleeding by ISTH criteria was a key secondary outcome. Apixaban reduced stroke/systemic embolism to 3.2% versus 5.8% with warfarin (hazard ratio 0.55, 95% CI 0.32-0.95). Major bleeding occurred in 2.1% on apixaban and 3.9% on warfarin (hazard ratio 0.53). All-cause mortality did not differ between groups. Participants with mechanical heart valves or eGFR below 30 mL/min/1.73 m^2 were excluded. Time in therapeutic range for warfarin averaged 62%. Treatment discontinuation was less frequent with apixaban, and no hepatic safety signal emerged.",
    "subclaim": "Apixaban dose was reduced for low body weight.",
    "label": "not_supported"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "Children aged 6 to 17 were enrolled.",
    "label": "supported"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "All participants received albuterol, ipratropium, and dexamethasone.",
    "label": "supported"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "Magnesium sulfate reduced 4-hour admissions.",
    "label": "supported"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "Mild flushing was more common with magnesium.",
    "label": "supported"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "Adults were included.",
    "label": "refuted"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "The control group received no inhaled bronchodilators.",
    "label": "refuted"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "Oxygen saturation improved at 2 hours with magnesium.",
    "label": "refuted"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "Patients with suspected pneumonia were included.",
    "label": "refuted"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "Emergency department length of stay was shorter with magnesium.",
    "label": "not_supported"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "Benefit was greater in children under 10.",
    "label": "not_supported"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "PRAM scores improved more at 30 minutes.",
    "label": "not_supported"
  },
  {
    "text": "A prospective, randomized, placebo-controlled trial in a pediatric emergency department evaluated nebulized magnesium sulfate added to standard therapy for acute asthma. Children aged 6 to 17 years with moderate to severe exacerbations by PRAM score were enrolled. All participants received inhaled albuterol and ipratropium plus oral dexamethasone. The intervention arm received two nebulized doses of magnesium sulfate; the control arm received matched saline. The primary outcome was hospital admission within 4 hours. Admissions occurred in 32% with magnesium versus 48% with placebo (adjusted odds ratio 0.52, 95% CI 0.34-0.80). Heart rate and oxygen saturation at 2 hours did not differ between groups. Mild flushing was more common with magnesium, and no serious adverse events were reported. Patients with fever or suspected pneumonia were excluded.",
    "subclaim": "Seven-day relapse rates were lower with magnesium.",
    "label": "not_supported"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "Triple therapy reduced exacerbations versus dual bronchodilators.",
    "label": "supported"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "Trough FEV1 increased with triple therapy.",
    "label": "supported"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "Pneumonia was more frequent with triple therapy.",
    "label": "supported"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "Mortality was unchanged at 12 months.",
    "label": "supported"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "The trial excluded current smokers.",
    "label": "refuted"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "Adherence was lower in the triple-therapy arm.",
    "label": "refuted"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "Triple therapy reduced pneumonia risk.",
    "label": "refuted"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "Quality of life worsened on triple therapy.",
    "label": "refuted"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "The intervention was cost-effective.",
    "label": "not_supported"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "Pulmonary rehabilitation was required for enrollment.",
    "label": "not_supported"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "The study was conducted across multiple countries.",
    "label": "not_supported"
  },
  {
    "text": "Adults aged 45–80 with severe COPD were randomized in a community clinic trial to once-daily triple inhaler therapy (ICS/LABA/LAMA) or dual bronchodilator therapy (LABA/LAMA). Over 12 months, the triple therapy group had a 22% lower annual exacerbation rate than the dual group. Trough FEV1 improved by a mean of 90 mL with triple therapy compared with dual therapy. Health-related quality of life improved by 4 units on a validated scale in the triple arm. Pneumonia occurred in 6% of triple-therapy patients versus 3% on dual therapy. All-cause mortality did not differ between groups during follow-up. Adherence to assigned inhalers was similar in both arms. Participants included both current smokers and former smokers, and those with blood eosinophils ≥300 cells/µL appeared to derive greater benefit.",
    "subclaim": "Exacerbation benefits persisted beyond two years.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "ED discharges increased after implementation.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "Length of stay decreased by 2.1 hours.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "No deaths occurred in the rule-out group.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "CKD patients used a 0/3-hour pathway.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "MACE doubled after the algorithm was adopted.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "Invasive angiography rates increased substantially.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "Staff adherence was under half of eligible cases.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "Positive troponin without MI diagnosis became less common in women.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "A high-sensitivity troponin T assay was used.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "The setting was a rural hospital network.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "Implementation reduced cost per patient by 20%.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain. Compared with the prior usual-care period, the proportion discharged directly from the ED increased from 28% to 45%. Median length of stay decreased by 2.1 hours after implementation. Thirty-day major adverse cardiac events in the rule-out group were 0.3%, similar to 0.4% during the historical control period. There were no deaths among patients classified as rule-out. Women showed a slightly higher rate of positive troponin results without a final diagnosis of myocardial infarction. The overall rate of invasive coronary angiography did not change. Staff adherence to the algorithm reached 88%. Patients with known chronic kidney disease were managed using a 0/3-hour pathway.",
    "subclaim": "The median patient age exceeded 70 years.",
    "label": "not_supported"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Adults within 4.5 hours of onset were randomized.",
    "label": "supported"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Tenecteplase was given as a single IV bolus.",
    "label": "supported"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Door-to-needle time was shorter with tenecteplase.",
    "label": "supported"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Ninety-day mortality was similar between groups.",
    "label": "supported"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Children were enrolled in the trial.",
    "label": "refuted"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Tenecteplase required a prolonged infusion.",
    "label": "refuted"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Recent DOAC use was allowed for enrollment.",
    "label": "refuted"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Mortality was higher with tenecteplase.",
    "label": "refuted"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "The trial was funded by the drug manufacturer.",
    "label": "not_supported"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Benefit was limited to patients aged over 80.",
    "label": "not_supported"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Tenecteplase improved 24-hour NIHSS scores.",
    "label": "not_supported"
  },
  {
    "text": "At 22 stroke centers, adults with acute ischemic stroke presenting within 4.5 hours were randomized to intravenous tenecteplase 0.25 mg/kg (single bolus) or alteplase 0.9 mg/kg (bolus plus infusion). The primary outcome, functional independence (modified Rankin Scale 0–1) at 90 days, met noninferiority for tenecteplase compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar rates in both groups. Door-to-needle time was shorter in the tenecteplase arm, reflecting the ease of single-bolus administration. Patients with intracranial hemorrhage on initial CT or recent use of direct oral anticoagulants within 48 hours were excluded. All-cause mortality at 90 days did not differ between groups. In the prespecified subgroup with large-vessel occlusion proceeding to thrombectomy, early reperfusion before the first device pass was more frequent with tenecteplase. Serious adverse events were comparable across arms. The trial did not identify differences in hospital length of stay.",
    "subclaim": "Home-time days were higher with tenecteplase.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "Emergency physicians performed the point-of-care ultrasounds.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "Ultrasound sensitivity for appendicitis was 88%.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "CT utilization decreased after the pathway started.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "Ultrasound exams did not require procedural sedation.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "The study was retrospective.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "Radiologists performed all ultrasounds.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "CT was used first-line in every patient.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "Ultrasound specificity was below 70%.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "More than 1000 patients were enrolled.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "The pathway reduced hospital costs.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "Interobserver agreement had a kappa of 0.80.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort at two urban pediatric emergency departments evaluated a point-of-care ultrasound pathway for suspected appendicitis. Trained emergency physicians performed standardized right lower quadrant ultrasound before any advanced imaging. Positive or indeterminate scans prompted surgical consultation and, when needed, MRI, while CT was reserved for discordant cases. The reference standard was operative pathology or 30-day clinical follow-up. Ultrasound sensitivity was 88% and specificity 94% for appendicitis. After implementation, CT utilization fell from 36% to 12% without an increase in perforation rates. The protocol reduced median emergency department length of stay by 40 minutes. No procedural sedation was required for the ultrasound examinations. Missed appendicitis at 7 days was rare and similar to the pre-implementation period.",
    "subclaim": "The study spanned five years.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "Systolic blood pressure reductions were similar between groups.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "Lisinopril reduced albuminuria more than amlodipine.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "Hyperkalemia was more frequent with lisinopril.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "Patients with diabetes were excluded.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "Amlodipine produced greater ACR reduction than lisinopril.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "Dry cough was more common with amlodipine.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "The eGFR declined faster with lisinopril than with amlodipine.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "Participants with baseline potassium above 5.0 mmol/L were eligible.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "Mean participant age was 62 years.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "Medication adherence exceeded 90%.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 412 adults with stage 3 chronic kidney disease and uncontrolled hypertension. Participants were assigned to lisinopril 20 mg daily or amlodipine 10 mg daily for 12 months, with both groups receiving low-sodium diet counseling. The primary outcome was change in urine albumin-to-creatinine ratio (ACR), with secondary outcomes of systolic blood pressure, eGFR slope, hyperkalemia events, and cough. Systolic blood pressure fell by about 13 mmHg in both groups. Median ACR declined more with lisinopril (−32%) than with amlodipine (−12%). Hyperkalemia occurred in 8% on lisinopril versus 2% on amlodipine, and dry cough in 9% versus 3%, respectively. The rate of eGFR decline did not differ significantly between groups. The trial excluded patients with diabetes and those with baseline serum potassium above 5.0 mmol/L. Adverse events were adjudicated by a blinded committee.",
    "subclaim": "Protein restriction was mandated for all participants.",
    "label": "not_supported"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "Adults with suspected appendicitis were randomized.",
    "label": "supported"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "Ultrasound-first reduced radiation exposure.",
    "label": "supported"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "Time to disposition was longer in the ultrasound-first arm.",
    "label": "supported"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "Negative appendectomy rates did not differ significantly.",
    "label": "supported"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "Ultrasound-first shortened time to disposition.",
    "label": "refuted"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "Pediatric patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "No missed appendicitis occurred in the ultrasound-first arm.",
    "label": "refuted"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "The ultrasound-first pathway avoided CT in all cases.",
    "label": "refuted"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "The median age of participants was 36 years.",
    "label": "not_supported"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "Ultrasounds were performed by emergency physicians.",
    "label": "not_supported"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "The ultrasound-first pathway reduced costs.",
    "label": "not_supported"
  },
  {
    "text": "A single-center pragmatic trial randomized 286 adults presenting with suspected appendicitis to an ultrasound-first pathway or immediate CT. All patients received a surgical consult; in the ultrasound-first arm, CT was performed only if ultrasound was nondiagnostic. The primary outcome was the negative appendectomy rate. Secondary outcomes included time to disposition, perforation rate, 30-day missed appendicitis, and cumulative radiation dose. The ultrasound-first strategy reduced mean radiation exposure by 7.4 mSv per patient compared with immediate CT. Median time to disposition was longer in the ultrasound-first arm by 1.3 hours. Negative appendectomy rates were 4.1% with ultrasound-first and 3.7% with CT, a non-significant difference. Perforation rates were similar between groups (17% vs 16%). Two missed appendicitis cases occurred in the ultrasound-first arm, with none in the immediate CT arm. In the ultrasound-first arm, 58% ultimately underwent CT after a nondiagnostic ultrasound.",
    "subclaim": "Pregnant patients were excluded from enrollment.",
    "label": "not_supported"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "The trial enrolled adults with stage 3b chronic kidney disease.",
    "label": "supported"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "Dapagliflozin halved albuminuria versus placebo.",
    "label": "supported"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "Systolic blood pressure dropped by 4 mmHg with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "Genital mycotic infections were more frequent with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "Only patients with type 2 diabetes were enrolled.",
    "label": "refuted"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "Dapagliflozin significantly reduced heart failure hospitalizations.",
    "label": "refuted"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "Hyperkalemia was higher with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "Hypoglycemia was common in the trial.",
    "label": "refuted"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "All participants were from a single Asian country.",
    "label": "not_supported"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "Dapagliflozin improved health-related quality of life.",
    "label": "not_supported"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "Mean HbA1c fell more with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "NEPHRA-3 was a randomized, double-blind trial of dapagliflozin 10 mg daily versus placebo in 912 adults aged 40–85 with stage 3b chronic kidney disease and persistent albuminuria, all on stable ACE inhibitor or ARB therapy. Fifty-eight percent had type 2 diabetes, and the rest did not. Over 18 months, dapagliflozin slowed the chronic eGFR decline by 1.8 mL/min/1.73 m² per year compared with placebo. Median urine albumin-to-creatinine ratio fell by about 50% in the dapagliflozin group. Office systolic blood pressure decreased by 4 mmHg with dapagliflozin relative to placebo. Rates of hyperkalemia and acute kidney injury were similar between groups. Genital mycotic infections were more frequent with dapagliflozin and were mostly mild. Hypoglycemia was uncommon and did not differ by diabetes status. Hospitalization for heart failure was numerically lower with dapagliflozin but not statistically different.",
    "subclaim": "All-cause mortality was lower with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "Noninvasive ventilation reduced intubation compared to high-flow nasal cannula.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "Arterial pH improved more at 2 hours with noninvasive ventilation.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "In-hospital mortality was similar between groups.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "Nasal bridge skin breakdown was more frequent with noninvasive ventilation.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "The study was single-center.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "All patients were intubated within 48 hours.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "Patient comfort at 24 hours favored noninvasive ventilation.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "High-flow nasal cannula reduced intubation compared to noninvasive ventilation.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "Length of hospital stay was shorter with noninvasive ventilation.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "PaCO2 decreased more with high-flow nasal cannula.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "90-day readmission was lower with noninvasive ventilation.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 286 adults with acute exacerbation of COPD and moderate hypercapnic respiratory acidosis (pH 7.25–7.35, PaCO2 > 50 mmHg). Participants were assigned to noninvasive ventilation via oronasal mask or high-flow nasal cannula oxygen therapy in the emergency department. The primary outcome was endotracheal intubation within 48 hours. Intubation occurred less often with noninvasive ventilation than with high-flow nasal cannula (14% vs 26%). Improvement in arterial pH at 2 hours was greater with noninvasive ventilation. In-hospital mortality did not differ between groups. Skin breakdown at the nasal bridge was more frequent with noninvasive ventilation, while high-flow nasal cannula caused more dry mouth reports. Patient-reported comfort at 24 hours favored high-flow nasal cannula.",
    "subclaim": "Sedation use was higher in the noninvasive ventilation group.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "Dapagliflozin lowered UACR versus placebo.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "eGFR decline was slower with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "DKA did not occur in the trial.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "Type 1 diabetes was an exclusion.",
    "label": "supported"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "Participants with eGFR below 45 were included.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "HbA1c was unchanged in the active arm.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "Serious adverse events were higher with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "Insulin doses were increased during the study.",
    "label": "refuted"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "Dapagliflozin reduced fracture risk.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "Most participants were women.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "Heart failure patients were excluded.",
    "label": "not_supported"
  },
  {
    "text": "An investigator-initiated randomized trial enrolled adults with type 2 diabetes and an estimated glomerular filtration rate between 45 and 90 mL/min/1.73 m². Participants were assigned to dapagliflozin 10 mg daily or matching placebo for 48 weeks. Dapagliflozin reduced urine albumin-to-creatinine ratio by 28% versus placebo and slowed the rate of eGFR decline by about 1.5 mL/min/1.73 m² per year. Systolic blood pressure fell modestly and HbA1c decreased by 0.4% in the active arm, while background insulin doses were kept unchanged per protocol. Genital mycotic infections occurred more often with dapagliflozin, but serious adverse events were similar between groups. Diabetic ketoacidosis was not observed in either arm. The trial excluded people with type 1 diabetes and those with baseline eGFR below 45. Effects were consistent among participants aged 65 years and older.",
    "subclaim": "Weight loss averaged 5 kg with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "An ultrasound-first pathway was used.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "CT was used after nondiagnostic ultrasound.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "CT use fell to 18% from a 42% baseline.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "Missed appendicitis did not increase at 7 days.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "Only adults were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "Ultrasound sensitivity was below 50%.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "Imaging routinely required sedation.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "Radiation exposure increased during the study.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "Emergency department length of stay decreased.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "MRI replaced CT in most cases.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "The study showed lower costs.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study evaluated children aged 5 to 17 years with suspected appendicitis in two urban emergency departments. An ultrasound-first diagnostic pathway was implemented, with computed tomography reserved for nondiagnostic sonography and ongoing clinical concern. Ultrasound performed by experienced sonographers achieved 88% sensitivity and 94% specificity for appendicitis. Compared with a historical baseline of 42%, CT utilization during the study fell to 18%. There was no increase in missed appendicitis on 7-day follow-up calls and record review. The negative appendectomy rate was 6% under the pathway. No sedation was required for ultrasound examinations. Overall radiation exposure from imaging decreased relative to prior practice.",
    "subclaim": "Pregnant adolescents were excluded.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "The study enrolled adults with HFpEF.",
    "label": "supported"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "Dapagliflozin improved KCCQ more than usual care.",
    "label": "supported"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "Heart failure hospitalization was lower with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "Genital infections were more frequent with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "The trial compared dapagliflozin to high-dose loop diuretics.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "Systolic blood pressure increased substantially with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "Diabetic ketoacidosis was more common with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "The cohort had reduced ejection fraction.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "All-cause mortality was reduced by dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "NT-proBNP levels fell by 30% with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "Black patients derived larger benefit than others.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter trial, 612 adults with heart failure with preserved ejection fraction (LVEF ≥50%) and NYHA II–III symptoms were randomized to dapagliflozin 10 mg daily or usual care for 9 months. Mean age was 72 years, and 47% had type 2 diabetes. The primary outcome, change in Kansas City Cardiomyopathy Questionnaire overall summary score, improved by 7.5 points with dapagliflozin versus 2.0 points with usual care. Heart failure hospitalization occurred in 8% of dapagliflozin patients compared with 13% on usual care. Systolic blood pressure changed minimally in both groups (−1.2 vs −1.0 mmHg). An initial dip in eGFR during the first month stabilized thereafter without between-group differences at 9 months. Genital mycotic infections were more frequent with dapagliflozin (6% vs 2%), while diabetic ketoacidosis was rare and similar across groups. Benefits were consistent in participants with and without diabetes.",
    "subclaim": "The study was funded by the drug manufacturer.",
    "label": "not_supported"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "Trained pediatricians performed the lung ultrasounds.",
    "label": "supported"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "LUS sensitivity was 88% for consolidation over 1 cm.",
    "label": "supported"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "An ultrasound-first pathway avoided chest X-ray in 48% of children.",
    "label": "supported"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "Interobserver kappa for lung ultrasound was 0.72.",
    "label": "supported"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "CT scanning was the reference standard.",
    "label": "refuted"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "All exams were performed by radiologists.",
    "label": "refuted"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "Radiation exposure increased with the ultrasound-first pathway.",
    "label": "refuted"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "Lung ultrasound had 98% specificity for consolidation.",
    "label": "refuted"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "Antibiotic prescribing rates were reduced with ultrasound-first.",
    "label": "not_supported"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "The study reported cost savings per patient.",
    "label": "not_supported"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "Mortality differed between diagnostic pathways.",
    "label": "not_supported"
  },
  {
    "text": "At a pediatric emergency department, 220 children aged 2 months to 12 years with suspected community-acquired pneumonia underwent point-of-care lung ultrasound by trained pediatricians. Chest radiography was obtained when clinically indicated and served as the reference for consolidation larger than 1 cm. Lung ultrasound showed sensitivity of 88% and specificity of 82% for detecting such consolidations. Using an ultrasound-first pathway, 48% of children avoided chest X-ray without a rise in 7-day return visits. Median emergency department length of stay was similar between pathways. False-positive ultrasound findings occurred mostly in viral bronchiolitis. Interobserver agreement for ultrasound interpretation was substantial (kappa 0.72). No adverse events were attributed to ultrasound.",
    "subclaim": "A smartphone-based probe was used for all scans.",
    "label": "not_supported"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "The trial enrolled adolescents aged 12-17.",
    "label": "supported"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "MART reduced severe exacerbations versus control.",
    "label": "supported"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "Rescue inhaler use was lower with MART.",
    "label": "supported"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "Oral candidiasis was more frequent with MART.",
    "label": "supported"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "The trial was double-blind.",
    "label": "refuted"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "Only adults older than 18 were enrolled.",
    "label": "refuted"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "Hospitalizations occurred only in the MART arm.",
    "label": "refuted"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "Resting heart rate increased with MART versus control.",
    "label": "refuted"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "Adherence was higher with MART.",
    "label": "not_supported"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "Nighttime awakenings decreased more with MART.",
    "label": "not_supported"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "Blood eosinophils predicted response to MART.",
    "label": "not_supported"
  },
  {
    "text": "At a tertiary pediatric center, a randomized, open-label trial enrolled 220 adolescents aged 12-17 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used for both maintenance and relief (MART) or to fixed-dose budesonide-formoterol with albuterol as needed. Over 24 weeks, the MART group had a 28% lower rate of severe exacerbations (0.42 vs 0.58 events per patient-year). Mean pre-bronchodilator FEV1 improved similarly in both arms, by about 140 mL. Daily rescue inhaler use was lower with MART by 0.6 puffs per day. Oral candidiasis occurred in 4% of MART vs 2% of control. Tremor rates were comparable between groups. No significant difference in resting heart rate was observed, and no hospitalizations occurred in either arm. The trial excluded current smokers and those with recent systemic steroid use.",
    "subclaim": "MART reduced cost per patient.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "Sex-specific troponin thresholds were used.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "64% were categorized as rule-out.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "No 30-day deaths occurred in the rule-out group.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "Chronic kidney disease was common in false-positive rule-in cases.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "The cohort was retrospective.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "Patients with ST-elevation were included.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "Ten percent of rule-out patients had MI at 30 days.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "Rule-out patients had longer stays than observation patients.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "A 12-month mortality analysis was reported.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "The algorithm reduced hospital admissions by 20%.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "Women had higher false-positive rates than men.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort of 1,480 adults presenting with chest pain to three emergency departments was evaluated with a high-sensitivity troponin I 0/1-hour algorithm. Using sex-specific thresholds, 64% were categorized as rule-out, 13% as rule-in, and 23% as observation. Median length of stay was 4.1 hours in rule-out compared with 9.3 hours in observation. At 30 days, myocardial infarction occurred in 0.3% of rule-out patients and 58% of rule-in patients. No deaths occurred in the rule-out group by 30 days. Chronic kidney disease was common in false-positive rule-in cases. The algorithm's negative predictive value for MI at 30 days was 99.7%. Antiplatelet therapy was initiated in nearly all rule-in patients before admission. The study excluded patients with ST-elevation on the index ECG.",
    "subclaim": "Major bleeding occurred in 5% after antiplatelet therapy.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "Semaglutide lowered HbA1c more than glimepiride at 24 weeks.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "Semaglutide caused weight loss.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "Nausea was common with semaglutide.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "Symptomatic hypoglycemia was less frequent on semaglutide than glimepiride.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "The trial enrolled patients with type 1 diabetes.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "Treatment duration was 12 months.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "Glimepiride led to weight loss.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "Pancreatitis occurred in the semaglutide arm.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "HbA1c was measured using a point-of-care device.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "Participants were mostly female.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "The study excluded patients with cardiovascular disease.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter trial evaluated semaglutide versus glimepiride as add-on to metformin in adults with type 2 diabetes inadequately controlled at baseline HbA1c 8.3%. Participants were randomized to semaglutide 1 mg weekly or glimepiride 4 mg daily for 24 weeks. By week 24, mean HbA1c decreased by 1.7% with semaglutide and by 1.0% with glimepiride. Semaglutide produced a mean weight loss of 4.2 kg, whereas glimepiride patients gained 1.1 kg. Documented symptomatic hypoglycemia occurred in 4% on semaglutide and 12% on glimepiride. Nausea and decreased appetite were the most common adverse effects with semaglutide, usually transient. Serum creatinine and eGFR remained stable without between-group differences. No patient had pancreatitis. Adherence exceeded 90% in both arms.",
    "subclaim": "The trial was conducted in Japan.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "The 0/1-hour hs-cTnI algorithm reduced ED length of stay.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "End-stage renal disease patients were excluded.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "Negative predictive value for rule-out was 99.7%.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "No missed STEMI cases occurred.",
    "label": "supported"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "Conventional 6-hour troponin testing was the primary strategy.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "Early discharge 30-day MI or cardiac death was 10%.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "Implementation increased antiplatelet use at discharge.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "Mild chronic kidney disease reduced algorithm performance.",
    "label": "refuted"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "Median age was 62 years.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "Women had higher false positive rates.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "Beta-blocker use at discharge increased.",
    "label": "not_supported"
  },
  {
    "text": "In a prospective emergency department study, adults presenting with acute chest pain were evaluated using a high-sensitivity troponin I 0/1-hour algorithm. Patients with baseline hs-cTnI below 5 ng/L and a 1-hour change less than 2 ng/L were triaged to early discharge with outpatient follow-up. Those with elevated values or significant deltas underwent cardiology admission and further testing, including coronary CT angiography when appropriate. Compared with conventional 6-hour troponin testing, the algorithm reduced median ED length of stay from 7.1 to 3.9 hours. At 30 days, the rate of myocardial infarction or cardiac death in the early discharge group was 0.3%. No cases of missed ST-elevation myocardial infarction were identified. The negative predictive value for the rule-out arm was 99.7%. Mild chronic kidney disease did not affect algorithm performance, but end-stage renal disease patients were excluded. Implementation did not change the overall use of antiplatelet therapy at discharge.",
    "subclaim": "Coronary CT angiography reduced invasive angiography rates.",
    "label": "not_supported"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "The low-sodium DASH diet lowered 24-hour systolic BP more than usual care.",
    "label": "supported"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "eGFR did not differ between groups during 12 weeks.",
    "label": "supported"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "Four percent of the diet arm had potassium ≥5.5 mmol/L.",
    "label": "supported"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "Participants were adults with stage 3 CKD and hypertension.",
    "label": "supported"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "Dialysis patients were included.",
    "label": "refuted"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "Weight loss explained the blood pressure reduction.",
    "label": "refuted"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "Arrhythmias increased in the diet group.",
    "label": "refuted"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "Sodium intake did not change in the diet group.",
    "label": "refuted"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "Black participants had larger BP reductions than others.",
    "label": "not_supported"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "The diet reduced cardiovascular events.",
    "label": "not_supported"
  },
  {
    "text": "A 12-week randomized, parallel-group trial enrolled 180 adults aged 40–75 with stage 3 chronic kidney disease and hypertension; no participants were on dialysis. Participants were assigned to a low-sodium DASH diet targeting 1500 mg sodium/day plus usual care, or to usual care alone. The primary outcome was change in 24-hour systolic blood pressure measured by ambulatory monitoring. Mean systolic pressure fell by 9.4 mmHg in the diet group versus 2.1 mmHg with usual care (p<0.001). Serum potassium rose modestly in the diet group by 0.3 mmol/L, and 4% had values ≥5.5 mmol/L, without arrhythmias or hospitalizations. Estimated GFR did not differ between groups over 12 weeks. Adherence, evidenced by a 24-hour urinary sodium reduction, reached 78% in the diet arm. Body weight and physical activity were unchanged between groups.",
    "subclaim": "Diuretic use decreased during follow-up.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "More than half of patients were ruled out within two hours.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "The ruled-out group had 0.3% 30-day MI or cardiac death.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "Length of stay fell by about one hour after implementation.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "Specificity was lower with eGFR <60 mL/min/1.73m2.",
    "label": "supported"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "ST-elevation MI patients were included.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "A 3-hour troponin sample was required.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "Hospital admissions increased after adoption.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "Thirty-day mortality increased with the algorithm.",
    "label": "refuted"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "The study was randomized.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "Women had higher NPV than men.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "Implementation reduced costs by 20%.",
    "label": "not_supported"
  },
  {
    "text": "A prospective multicenter study implemented a 0/1-hour high-sensitivity troponin I algorithm for adults presenting with chest pain to three emergency departments. Patients with ST-elevation myocardial infarction were excluded by ECG at triage. The protocol required baseline and 1-hour troponin measurements to rule out myocardial infarction. Overall, 54% of 2,400 patients were ruled out within two hours and discharged from the ED. Among those ruled out, 30-day myocardial infarction or cardiac death occurred in 0.3%, yielding a negative predictive value of 99.7%. After implementation, hospital admission rates fell from 62% to 45%, and median length of stay dropped by 1.1 hours. There was no increase in missed infarctions or 30-day mortality. Specificity was lower in patients with estimated GFR below 60 mL/min/1.73m2 than in those with normal kidney function.",
    "subclaim": "Beta-blocker use altered troponin assay performance.",
    "label": "not_supported"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Semaglutide lowered HbA1c more than metformin.",
    "label": "supported"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Nausea occurred more frequently with semaglutide.",
    "label": "supported"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Weight loss was greater with semaglutide.",
    "label": "supported"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Participants with eGFR under 60 were excluded.",
    "label": "supported"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Pregnant individuals were enrolled.",
    "label": "refuted"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Systolic blood pressure increased with semaglutide.",
    "label": "refuted"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Severe hypoglycemia was common.",
    "label": "refuted"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Pancreatitis occurred in several patients.",
    "label": "refuted"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Semaglutide improved quality of life scores.",
    "label": "not_supported"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Metformin caused more diarrhea than semaglutide.",
    "label": "not_supported"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "Black participants were underrepresented.",
    "label": "not_supported"
  },
  {
    "text": "At 12 sites, 312 adults aged 30 to 70 with newly diagnosed type 2 diabetes (HbA1c 7.5 to 10.5 percent) were randomized to once-weekly semaglutide 1 mg or metformin 2000 mg daily for 24 weeks. Participants with eGFR less than 60 mL/min/1.73 m2 or pregnancy were excluded. The primary endpoint was change in HbA1c; secondary endpoints included body weight, systolic blood pressure, and symptomatic hypoglycemia. Mean HbA1c fell by 1.7 percentage points with semaglutide versus 1.1 percentage points with metformin (p<0.001). Weight decreased by 5.6 kg with semaglutide and 2.1 kg with metformin (p<0.001). Systolic blood pressure fell by about 3 mmHg in both groups, with no between-group difference. Nausea was more common with semaglutide (18 percent vs 7 percent), while symptomatic hypoglycemia was rare and similar (2 percent vs 1 percent). No pancreatitis, severe hypoglycemia, or study drug-related hospitalizations occurred.",
    "subclaim": "The treatment effects persisted at 52 weeks.",
    "label": "not_supported"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "DWI-MRI had higher sensitivity for ischemic stroke than CT.",
    "label": "supported"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "MRI had a longer door-to-imaging time than CT.",
    "label": "supported"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "Some patients required sedation for MRI.",
    "label": "supported"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "Patients with non-MRI-compatible implants were excluded.",
    "label": "supported"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "Gadolinium contrast was used for MRI.",
    "label": "refuted"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "CT missed all intracranial hemorrhages.",
    "label": "refuted"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "The study included patients younger than 40.",
    "label": "refuted"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "CT was more sensitive than MRI for ischemic stroke.",
    "label": "refuted"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "MRI use increased intravenous thrombolysis rates.",
    "label": "not_supported"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "Thirty-day functional outcomes were better with MRI-first imaging.",
    "label": "not_supported"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "Imaging costs were lower with CT.",
    "label": "not_supported"
  },
  {
    "text": "Prospective study at two emergency departments enrolled 228 adults aged 65 or older with suspected acute stroke within 6 hours of onset. All patients received non-contrast head CT followed by diffusion-weighted MRI; those with non-MRI-compatible implants were excluded. Final stroke diagnosis was adjudicated by a blinded panel using 30-day clinical follow-up and vascular imaging. Sensitivity for ischemic stroke was 92 percent with DWI-MRI and 62 percent with CT, while specificity was 88 percent and 95 percent, respectively. Median door-to-imaging time was 22 minutes for CT and 54 minutes for MRI. MRI required short sedation in 8 percent but no contrast agents were used. CT identified all cases of intracranial hemorrhage in the cohort. Motion artifacts caused 3 percent false-positive MRI readings.",
    "subclaim": "Inter-rater agreement for MRI reads exceeded 0.9.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "Short-course adherence was higher than standard-course.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "Noninferiority for clinical cure at day 14 was met.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "Diarrhea was less frequent with 5 days than with 10 days.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "No deaths occurred in the trial.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "The trial enrolled adults older than 18 years.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "Children with beta-lactam allergy were included.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "Macrolide antibiotics were permitted during treatment.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "Only the standard-dose arm had hospitalizations.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "The short course reduced cost of care.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "Viral coinfections were more common in the short-course arm.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "Short therapy lowered nasopharyngeal antibiotic resistance.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 320 children aged 6 to 59 months with radiographically confirmed mild to moderate community-acquired pneumonia. Participants were assigned to 5 days of high-dose amoxicillin (90 mg/kg/day in three doses) or 10 days of standard-dose amoxicillin (45 mg/kg/day in two doses). The primary outcome was clinical cure at day 14 judged by blinded clinicians. Cure occurred in 88% of the short-course group and 86% of the standard-course group, a 2% difference (95% CI -5 to 9) meeting a -10% noninferiority margin. Diarrhea was reported in 9% on short-course vs 15% on standard-course therapy. Adherence by bottle weight was higher with short-course (92%) than standard-course (78%). Within 30 days, two hospitalizations occurred in each arm; there were no deaths and no Clostridioides difficile cases. Exclusions included severe disease, beta-lactam allergy, recent antibiotics, and macrolides were not allowed during treatment.",
    "subclaim": "Vaccination status affected the cure rates.",
    "label": "not_supported"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "IV ferric carboxymaltose increased hemoglobin more than oral iron.",
    "label": "supported"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "Hypophosphatemia was more frequent in the IV arm.",
    "label": "supported"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "Gastrointestinal events were more common with oral ferrous sulfate.",
    "label": "supported"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "Two mild infusion reactions occurred.",
    "label": "supported"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "Participants were younger than 50 years.",
    "label": "refuted"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "The trial was double-blind.",
    "label": "refuted"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "Serious infections were higher with IV iron.",
    "label": "refuted"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "Patients with active bleeding were included.",
    "label": "refuted"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "IV iron reduced 90-day hospitalizations.",
    "label": "not_supported"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "Ferritin normalized in all IV recipients.",
    "label": "not_supported"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "Pre-infusion hypersensitivity testing was performed.",
    "label": "not_supported"
  },
  {
    "text": "A four-center pragmatic open-label trial randomized 180 adults aged 65 years and older with iron deficiency anemia to intravenous ferric carboxymaltose or oral ferrous sulfate. The IV regimen was two 750 mg doses one week apart, while the oral regimen was 325 mg twice daily for eight weeks. The primary endpoint was hemoglobin increase at week 8. Mean hemoglobin rose 2.1 g/dL with IV iron versus 1.3 g/dL with oral iron, a 0.8 g/dL difference (95% CI 0.5 to 1.1) favoring IV. Hypophosphatemia under 2.5 mg/dL occurred in 14% on IV iron and 1% on oral, all asymptomatic. Gastrointestinal adverse events were more frequent with oral therapy (nausea 22%, constipation 18%) than with IV iron (8% any). Six-minute walk distance improved by 38 meters on IV vs 20 meters on oral iron. Exclusions included eGFR under 15, active bleeding, and recent transfusion; serious infections were not increased in either group. Two infusion reactions occurred, both mild and self-limited.",
    "subclaim": "Quality of life improved more with IV iron.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "Adults with type 2 diabetes and albuminuria were enrolled.",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "The trial lasted 24 weeks.",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "Dapagliflozin lowered UACR versus placebo.",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "No diabetic ketoacidosis occurred.",
    "label": "supported"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "Patients with eGFR below 30 mL/min/1.73 m² were included.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "Systolic blood pressure increased with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "Urinary tract infection rates were higher with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "The study was open-label.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "ACE inhibitor use was required.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "Dapagliflozin caused 3 kg weight loss.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "Most participants were women.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, double-blind trial evaluated dapagliflozin versus placebo in adults with type 2 diabetes and albuminuric chronic kidney disease. 412 participants were randomized 1:1 for 24 weeks; mean age was 58 years and baseline eGFR averaged 45 mL/min/1.73 m², with those below 30 mL/min/1.73 m² excluded. The primary outcome was percent change in urinary albumin-to-creatinine ratio (UACR). Dapagliflozin reduced UACR by 28% from baseline compared with a 3% reduction on placebo, yielding a between-group difference of −25% (p<0.001). The annualized decline in eGFR was projected to be 1.6 mL/min/1.73 m² slower with dapagliflozin than with placebo. HbA1c fell by 0.4% on dapagliflozin versus 0.1% on placebo, and systolic blood pressure decreased by 4 mmHg versus 1 mmHg respectively. Rates of urinary tract infection were similar between groups, while mild genital mycotic infections occurred more often with dapagliflozin. No cases of diabetic ketoacidosis were observed, and serious adverse events were balanced. The study was not powered to assess cardiovascular outcomes.",
    "subclaim": "Retinopathy progression improved.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "Children aged 6–11 were enrolled.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "The trial lasted 16 weeks.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "Budesonide improved FEV1 more than montelukast.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "Oral thrush occurred with budesonide.",
    "label": "supported"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "Adults were the study population.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "The trial lasted 52 weeks.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "Montelukast reduced exacerbations compared with budesonide.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "Long-acting beta-agonists were allowed.",
    "label": "refuted"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "Hospitalizations were reduced.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "Montelukast caused liver enzyme elevation.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "Most participants were male.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, double-blind trial compared once-daily low-dose inhaled budesonide with nightly montelukast in children aged 6 to 11 years with mild persistent asthma. 268 participants were treated for 16 weeks, with mean age 8.7 years and similar baseline lung function. The primary endpoint was change in weekly nighttime awakenings due to asthma. Budesonide reduced awakenings by 1.2 per week versus 0.6 with montelukast. Prebronchodilator FEV1 improved by 9% predicted with budesonide and 4% with montelukast. Exacerbations needing systemic corticosteroids occurred in 12% on budesonide versus 20% on montelukast. Oral thrush was reported in 4% of children receiving budesonide; no serious drug-related events occurred. Annualized growth velocity was 0.7 cm/year lower with budesonide than with montelukast. Use of long-acting beta-agonists was prohibited during the study.",
    "subclaim": "Eosinophil counts decreased.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "Procalcitonin guidance reduced antibiotic days.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "Pediatric patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "Twenty-eight–day mortality was similar between groups.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "C. difficile infection was lower in the procalcitonin arm.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "Pregnant patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "The protocol led to longer ICU stays.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "Antibiotics were stopped only when procalcitonin exceeded 2 µg/L.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "Reinfection rates increased with the protocol.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "Antifungal use decreased in the intervention arm.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "Ninety-day mortality was reduced.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "The trial was funded by a diagnostics company.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial evaluated a procalcitonin-guided antibiotic discontinuation protocol in ICU adults with suspected bacterial sepsis. 1,104 patients (mean age 62) were enrolled from 22 tertiary ICUs in Europe and North America; pediatric, pregnant, and profoundly immunosuppressed patients were excluded. In the intervention arm, clinicians stopped antibiotics when procalcitonin fell below 0.5 µg/L or declined by at least 80% from baseline. Over 28 days, antibiotic exposure was reduced (median 6 vs 9 days with usual care; p<0.001). Twenty-eight–day mortality was similar between groups (21% vs 22%), meeting the prespecified non-inferiority margin. ICU length of stay and documented reinfection rates did not increase with the protocol. Clostridioides difficile infections were less frequent in the procalcitonin arm. No serious adverse events were attributed to biomarker testing, and the protocol was adherent in 83% of intervention patients.",
    "subclaim": "Most infections were urinary in origin.",
    "label": "not_supported"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "Dialysis patients with end-stage renal disease were excluded.",
    "label": "supported"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "Hospital admissions decreased with the pathway.",
    "label": "supported"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "ED length of stay was shorter with the pathway.",
    "label": "supported"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "Thirty-day MI or cardiac death was similar between groups.",
    "label": "supported"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "The study was single-center.",
    "label": "refuted"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "The algorithm increased admission rates.",
    "label": "refuted"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "Pediatric patients were the main population.",
    "label": "refuted"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "Thirty-day mortality was higher with the pathway.",
    "label": "refuted"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "Sex-specific troponin thresholds were used.",
    "label": "not_supported"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "Per-patient costs were reduced.",
    "label": "not_supported"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "Myocarditis diagnoses increased after implementation.",
    "label": "not_supported"
  },
  {
    "text": "A stepped‑wedge cluster randomized evaluation tested a 0/1‑hour high‑sensitivity troponin pathway plus a clinical risk score for adults with chest pain in 14 urban emergency departments in Australia and Canada. Patients with ST‑elevation myocardial infarction, hemodynamic instability, or end‑stage renal disease on dialysis were excluded. The algorithm classified low‑risk patients for early discharge after negative troponin changes and a low risk score, while others underwent standard observation. Compared with usual 0/3‑hour testing, hospital admissions decreased from 54% to 38% during implementation. Median emergency department length of stay was 1.8 hours shorter with the pathway. Thirty‑day myocardial infarction or cardiac death was similar between periods (1.2% vs 1.3%), indicating no safety signal. Return emergency visits within 7 days did not increase, including among patients aged 70 years or older. Implementation did not change rates of aspirin or statin prescribing at discharge.",
    "subclaim": "Outpatient cardiology follow-up increased with the pathway.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Adults with moderate ulcerative colitis were studied.",
    "label": "supported"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Lumecaban was given orally.",
    "label": "supported"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Week 8 remission was higher with Lumecaban than placebo.",
    "label": "supported"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Patients under 18 were excluded.",
    "label": "supported"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Placebo achieved higher remission than Lumecaban.",
    "label": "refuted"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Lumecaban was administered intravenously.",
    "label": "refuted"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Serious adverse events were more frequent with Lumecaban.",
    "label": "refuted"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Biologic rescue therapy was allowed during blinding.",
    "label": "refuted"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Endoscopic mucosal healing improved with Lumecaban.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Lumecaban reduced corticosteroid use at week 8.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Quality of life scores improved with Lumecaban.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind, placebo-controlled trial evaluated Lumecaban, an oral JAK inhibitor, in adults with moderate ulcerative colitis refractory to mesalamine. Two hundred forty patients were randomized 1:1 to Lumecaban 200 mg daily or matched placebo for 8 weeks. Clinical remission at week 8 occurred in 34% of the Lumecaban group vs 12% with placebo (risk difference 22%, 95% CI 13–31). Median time to symptom response was 12 days with Lumecaban and 20 days with placebo. Serious adverse events were less frequent with Lumecaban (3%) than placebo (6%), while mild acne and transient transaminase elevations were more common with Lumecaban. The trial excluded patients under 18 years, pregnant individuals, and those with active infections. Rates of hospitalization for colitis flares through week 8 were 5% with Lumecaban vs 11% with placebo. No intravenous or biologic rescue therapy was permitted during the blinded phase.",
    "subclaim": "Benefits persisted at 24 weeks.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "Adults with chest pain were studied.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "STEMI patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "Sensitivity for 30-day MACE was 99.3%.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "Renal impairment increased false positives.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "The study included pediatric patients.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "More than 70% met rule-in criteria.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "The algorithm reduced 30-day mortality.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "Sex-specific troponin thresholds were applied.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "The study reported cost savings per patient.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "Coronary CT angiography was required.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "Median age was 60 years.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 500 adults presenting to the emergency department with chest pain. Patients with STEMI on initial ECG were excluded. Using predefined cutoffs, 56% were ruled out at 1 hour with a 30-day MACE negative predictive value of 99.8% and sensitivity of 99.3%. Eighteen percent met rule-in criteria, while the remaining patients entered observation. The algorithm shortened median ED length of stay by 1.6 hours compared with the prior standard. There was no difference in 30-day all-cause mortality compared with usual care. Among patients with estimated GFR below 45 mL/min/1.73 m2, false positive rates were higher. Sex-specific troponin thresholds were not used.",
    "subclaim": "Discharge antiplatelet use was reduced by the algorithm.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "Empagliflozin reduced heart failure hospitalization compared with glimepiride.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "HbA1c reduction was similar between groups.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "Genital infections were more frequent with empagliflozin.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "eGFR decline was slower with empagliflozin.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "Severe hypoglycemia was more common with empagliflozin.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "Participants with eGFR below 45 mL/min/1.73 m² were included.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "Retinopathy progression was lower with empagliflozin than glimepiride.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "Only single-center patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "All-cause mortality was reduced with empagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "The study was conducted in North America.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "Baseline BMI differed between groups.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter trial enrolled 1,200 adults aged 40–75 years with type 2 diabetes on metformin monotherapy. Participants were randomized to add empagliflozin 10 mg daily or glimepiride up to 8 mg daily and followed for 12 months. Hospitalization for heart failure was the primary outcome and occurred in 2.1% with empagliflozin versus 4.8% with glimepiride. Mean HbA1c reduction at 12 months was similar between groups (−0.8% vs −0.9%, p=0.12). Genital mycotic infections were more frequent with empagliflozin (9% vs 3%), while severe hypoglycemia was less common (0.5% vs 3.2%). Decline in estimated GFR was slower with empagliflozin (−1.2 vs −3.6 mL/min/1.73 m²). There was no between-group difference in diabetic retinopathy progression. Patients with eGFR below 45 mL/min/1.73 m², prior ketoacidosis, or pregnancy were excluded. Follow-up was completed in 94% of participants.",
    "subclaim": "Empagliflozin reduced albuminuria.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "Fluticasone increased asthma control days versus montelukast.",
    "label": "supported"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "Oral steroid-requiring exacerbations were fewer with fluticasone.",
    "label": "supported"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "Growth velocity was slightly reduced with fluticasone.",
    "label": "supported"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "Exhaled nitric oxide decreased more with fluticasone.",
    "label": "supported"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "Children younger than 3 years were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "Montelukast outperformed fluticasone for asthma control days.",
    "label": "refuted"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "Serious adverse events occurred only with fluticasone.",
    "label": "refuted"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "The trial lasted 12 months.",
    "label": "refuted"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "School absenteeism decreased more with fluticasone.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "Use of spacers was mandated.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "Blood eosinophil counts fell more with fluticasone.",
    "label": "not_supported"
  },
  {
    "text": "A randomized, multicenter trial enrolled 320 children aged 6–12 years with mild persistent asthma. Participants received either low-dose fluticasone 100 micrograms twice daily or montelukast 5 mg nightly for 24 weeks, with identical rescue albuterol plans. The primary endpoint, percentage of asthma control days, was higher with fluticasone (72% vs 58%, p<0.001). Exacerbations requiring oral corticosteroids occurred less often with fluticasone (14% vs 24%, p=0.03). Growth velocity over 24 weeks was slightly lower in the fluticasone group (2.4 cm vs 2.8 cm, p=0.02). Exhaled nitric oxide decreased more with fluticasone, indicating better airway inflammation control. Dysphonia and oral thrush were more frequent with fluticasone, while headache was more common with montelukast; serious adverse events were rare and similar between groups. Children with prior intubation for asthma were excluded, and baseline FEV1 averaged 92% predicted. Study completion was 92%.",
    "subclaim": "Secondhand smoke exposure modified treatment effect.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "Adults with type 2 diabetes and CKD stage 3–4 were enrolled.",
    "label": "supported"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "The trial was randomized and double-blind.",
    "label": "supported"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "Dapagliflozin lowered the primary renal composite versus placebo.",
    "label": "supported"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "No diabetic ketoacidosis occurred.",
    "label": "supported"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "Children were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "Type 1 diabetes was included.",
    "label": "refuted"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "The primary composite occurred more often with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "Systolic blood pressure rose with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "The study was industry funded.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "Over half of participants were Hispanic.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "Only the 10 mg dose of dapagliflozin was used.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter trial enrolled 1,840 adults with type 2 diabetes and stage 3–4 chronic kidney disease. All participants received a stable ACE inhibitor or ARB. Patients were randomized in a double-blind fashion to dapagliflozin or placebo. Median follow-up was 28 months. The primary composite of sustained 50% eGFR decline, kidney failure, or renal/cardiovascular death occurred less often with dapagliflozin than with placebo (hazard ratio 0.68). Hospitalizations for heart failure were also reduced in the dapagliflozin group. HbA1c decreased by about 0.3% at 12 months with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin than with placebo. No cases of diabetic ketoacidosis were observed. Systolic blood pressure fell by roughly 3 mmHg with dapagliflozin; key exclusions included type 1 diabetes and eGFR below 25 mL/min/1.73 m2.",
    "subclaim": "Dapagliflozin improved retinopathy progression.",
    "label": "not_supported"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "It was a prospective observational study.",
    "label": "supported"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "Troponin I was measured at 0 and 1 hours.",
    "label": "supported"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "ST-elevation MI cases were excluded.",
    "label": "supported"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "No deaths occurred at 30 days in the rule-out group.",
    "label": "supported"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "Only 10% were ruled out.",
    "label": "refuted"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "The negative predictive value was below 90%.",
    "label": "refuted"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "Pediatric patients were included.",
    "label": "refuted"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "Rule-in positive predictive value exceeded 90%.",
    "label": "refuted"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "The study was industry funded.",
    "label": "not_supported"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "Women comprised at least half of participants.",
    "label": "not_supported"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "The algorithm reduced 30-day myocardial infarction versus prior practice.",
    "label": "not_supported"
  },
  {
    "text": "We prospectively studied 1,200 adults presenting with chest pain to three emergency departments. A high-sensitivity troponin I 0/1-hour algorithm with ECG stratified patients into rule-out, observe, or rule-in groups. The primary endpoint was index myocardial infarction adjudicated by two cardiologists using standard criteria. The algorithm ruled out MI in 58% of patients with a negative predictive value of 99.5% and sensitivity of 98.8%. Rule-in classification occurred in 12% with a positive predictive value of 71%. Thirty-day major adverse cardiac events occurred in 0.7% of the rule-out group, and there were no deaths in that group. After implementation, hospital admission rates fell from 72% to 49%. ST-elevation myocardial infarctions were excluded a priori. In patients with eGFR under 45 mL/min/1.73 m2, specificity was lower and the positive predictive value declined. The protocol was not applied to patients younger than 18 years or those with active COVID-19 infection.",
    "subclaim": "A 0/3-hour sampling protocol was also evaluated.",
    "label": "not_supported"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "Dapagliflozin slowed eGFR decline versus placebo.",
    "label": "supported"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "Hospitalization for heart failure was reduced with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "Severe hypoglycemia rates were similar between groups.",
    "label": "supported"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "Type 1 diabetes patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "The trial lasted 12 weeks.",
    "label": "refuted"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "Mean participant age was 45 years.",
    "label": "refuted"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "All participants were women.",
    "label": "refuted"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "Dapagliflozin increased severe hypoglycemia.",
    "label": "refuted"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "Dapagliflozin reduced all-cause mortality.",
    "label": "not_supported"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "Retinopathy progression was slowed by dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "Black participants comprised 30% of the cohort.",
    "label": "not_supported"
  },
  {
    "text": "A 52-week randomized, double-blind trial enrolled adults with type 2 diabetes and stage 3 chronic kidney disease. Participants were assigned to dapagliflozin 10 mg daily or placebo on top of standard care including ACE inhibitors or ARBs. Mean age was 64 years, 40% were women, and median eGFR was 45 mL/min/1.73 m2 with albuminuria common. Patients with type 1 diabetes or eGFR below 30 were excluded. The primary endpoint was the annual rate of eGFR decline. Dapagliflozin slowed eGFR decline versus placebo by 1.8 mL/min/1.73 m2 per year and reduced hospitalization for heart failure. Rates of severe hypoglycemia were similar between groups. Genital mycotic infections were more frequent with dapagliflozin; ketoacidosis was rare and no study drug was stopped for it. Blood pressure fell modestly in the active arm without excess acute kidney injury.",
    "subclaim": "Insulin doses were reduced in the active arm.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "The algorithm reduced emergency department length of stay.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "48% of participants were women.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "Chronic kidney disease stage 4–5 patients were excluded.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "Use of invasive coronary angiography was reduced.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "Pediatric patients were included.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "Median age was 70 years.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "CT coronary angiography was mandated.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "The algorithm increased 30-day myocardial infarction or death.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "Major bleeding increased with the algorithm.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "The HEART score was required for risk stratification.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "Weekend presentations were excluded.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in three urban emergency departments evaluated a high-sensitivity troponin I 0/1-hour algorithm for adults presenting with chest pain. Patients with end-stage renal disease or known chronic kidney disease stage 4–5 were excluded. Median age was 58 years and 48% were women. Compared with usual care, the algorithm reduced median emergency department length of stay by 2.1 hours. The 30-day composite of myocardial infarction or death was similar between groups. Use of invasive coronary angiography was lower in the algorithm arm. No increase in missed myocardial infarctions was observed on blinded adjudication. Imaging protocols did not mandate CT coronary angiography, and no sedatives were used for biomarker testing. Staff received brief training on the protocol before rollout.",
    "subclaim": "Hospital readmissions at 90 days were reduced.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "The trial was double-blind.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "Participants were 18–65 years old.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "AeroCort reduced severe exacerbations vs budesonide.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "Trough FEV1 improved more with AeroCort.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "Children were included.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "The comparator was montelukast.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "QT prolongation was higher with AeroCort.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "Current smokers were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "Mean BMI was 29 kg/m2.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "Blood eosinophils predicted response.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "A run-in period preceded randomization.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized double-blind trial evaluated AeroCort (budesonide/formoterol fixed-dose) versus budesonide alone in adults 18–65 years with moderate persistent asthma uncontrolled on low-dose inhaled corticosteroid. Four hundred twelve patients, 52% female, had a baseline mean FEV1 of 68% predicted. Participants received AeroCort 160/4.5 micrograms two inhalations twice daily or budesonide 200 micrograms two inhalations twice daily for 24 weeks, with albuterol as rescue. The primary outcome was annualized severe exacerbation rate; secondary outcomes included change in trough FEV1, rescue use, ACQ-5, and adverse events. AeroCort reduced severe exacerbations by 32% versus budesonide (0.48 vs 0.71 per patient-year; rate ratio 0.68, p=0.01). Trough FEV1 increased by 210 mL with AeroCort versus 90 mL with budesonide (between-group difference 120 mL, p=0.02). Rescue albuterol puffs fell by 1.1/day with AeroCort versus 0.5/day with budesonide; oral candidiasis occurred in 3% versus 2%. There was no difference in serious adverse events or QT prolongation; current smokers and children were excluded.",
    "subclaim": "Cost-effectiveness was analyzed.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "ST-elevation MI at arrival was excluded.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "Troponin was measured at 0 and 1 hours.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "The rule-out miss rate for MI was 0.3%.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "ED length of stay decreased after implementation.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "Only women were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "Over half were classified as rule-in.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "No observation category was used.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "The admission rate increased after adoption.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "Prior coronary artery disease exceeded 40%.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "A point-of-care troponin device was used.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "Protocol compliance exceeded 95%.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort at three urban emergency departments evaluated a 0/1-hour high-sensitivity troponin I algorithm in adults presenting with chest pain within six hours of onset. The study enrolled 1,260 patients, median age 58 years, 43% female; those with ST-elevation myocardial infarction on arrival were excluded. Troponin was measured at arrival and one hour, and patients were assigned to rule-out, observe, or rule-in categories using predefined cutoffs with ECG and a clinical score. The primary endpoint was myocardial infarction within 30 days adjudicated by blinded cardiologists. The algorithm ruled out MI in 56% at one hour with a 30-day MI miss rate of 0.3% (sensitivity 99.3%, negative predictive value 99.7%). The rule-in category comprised 14% with a positive predictive value of 74%; the remaining 30% were classified as observation. Implementation reduced median emergency department length of stay from 6.1 to 4.2 hours compared with historical controls, and admission rate fell from 62% to 49%. There were no deaths in the rule-out group; patients with renal failure were not excluded.",
    "subclaim": "Cost savings were reported.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "ICU-requiring patients were excluded",
    "label": "supported"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "Day-14 cure rates were similar between groups",
    "label": "supported"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "GI upset was more common with azithromycin",
    "label": "supported"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "No 30-day deaths occurred",
    "label": "supported"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "Therapy duration was only three days",
    "label": "refuted"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "Azithromycin reduced hospitalizations versus doxycycline",
    "label": "refuted"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "Photosensitivity was more common with azithromycin",
    "label": "refuted"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "Macrolide resistance prevented azithromycin use",
    "label": "refuted"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "Smoking status influenced the cure rate",
    "label": "not_supported"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "Influenza vaccination improved outcomes",
    "label": "not_supported"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "Doxycycline was cheaper in this trial",
    "label": "not_supported"
  },
  {
    "text": "We conducted a single-center randomized open-label trial comparing azithromycin and doxycycline for outpatient community-acquired pneumonia in adults aged 18–85 years. Patients were assigned 1:1 to azithromycin 500 mg on day 1 then 250 mg on days 2–5 or to doxycycline 100 mg twice daily for 5 days. Individuals requiring ICU care, with severe immunosuppression, or recent antibiotic exposure were excluded. Clinical cure at day 14 was 82% in the azithromycin group and 80% in the doxycycline group, with no significant difference. Time to symptom resolution was similar (median 4 days in both arms), and 14-day hospitalization rates did not differ (9% vs 10%). No deaths occurred within 30 days in either group. Gastrointestinal upset was more frequent with azithromycin (18% vs 10%), while photosensitivity was more common with doxycycline (5% vs 1%). Local macrolide resistance was monitored but did not preclude azithromycin use during the study.",
    "subclaim": "Legionella was the most common pathogen",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "Ultrasound-first shortened ED stay",
    "label": "supported"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "Fewer ultrasound-first patients received any CT",
    "label": "supported"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "CT sensitivity for stones exceeded ultrasound sensitivity",
    "label": "supported"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "Thirty-day return visit rates were similar",
    "label": "supported"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "Only pregnant patients were enrolled",
    "label": "refuted"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "All ultrasound-first patients ultimately got CT",
    "label": "refuted"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "Ultrasound specificity was higher than CT specificity",
    "label": "refuted"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "Ultrasound found more alternative diagnoses than CT",
    "label": "refuted"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "Ultrasound-first saved over $500 per patient",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "Tamsulosin increased spontaneous stone passage",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "Stone size predicted need for urologic intervention",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic multicenter emergency department trial compared a point-of-care ultrasound-first strategy with a CT-first strategy for adults with suspected renal colic. Pregnant or hemodynamically unstable patients were excluded. In the ultrasound-first arm, scans were performed by credentialed emergency physicians. Using a composite reference, CT had sensitivity 97% and specificity 95% for ureteral stones, while ultrasound had sensitivity 72% and specificity 86%. Time to disposition was shorter with ultrasound-first (median 3.1 hours) than CT-first (4.5 hours). Only 38% of ultrasound-first patients received any CT, compared with 100% in the CT-first arm. Cumulative radiation exposure was lower with ultrasound-first (median 4 mSv vs 11 mSv). CT identified alternative diagnoses in 12% of cases versus 3% with ultrasound. Thirty-day return visits were similar between strategies (11% vs 12%), with no missed life-threatening diagnoses reported.",
    "subclaim": "Hydronephrosis grade predicted admission",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "The dual agonist lowered HbA1c more than glargine.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "Weight decreased with the dual agonist.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "Hypoglycemia was less frequent with the dual agonist.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "No pancreatitis occurred in the trial.",
    "label": "supported"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "Adolescents with type 1 diabetes were enrolled.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "eGFR declined less with the dual agonist than with glargine.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "The insulin group lost 5 kg on average.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "Patients with severe heart failure were included.",
    "label": "refuted"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "The dual agonist reduced diabetic retinopathy progression.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "Most participants were Asian.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "The dual agonist received FDA approval during the trial.",
    "label": "not_supported"
  },
  {
    "text": "An open-label, multicenter randomized trial enrolled 420 adults aged 40–75 years with type 2 diabetes, BMI ≥30 kg/m2, and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m2). Participants were on stable metformin and had HbA1c between 7.5% and 10%; those with type 1 diabetes or severe heart failure were excluded. Patients were assigned to a once-weekly dual GLP-1/GIP agonist or to nightly insulin glargine using treat-to-target algorithms. Follow-up was 48 weeks with prespecified visits. The primary endpoint was change in HbA1c; secondary outcomes included body weight, symptomatic hypoglycemia, blood pressure, and eGFR slope. Mean HbA1c fell by 1.8% with the dual agonist versus 1.1% with glargine (p<0.001). Body weight decreased by 7.4 kg with the dual agonist and increased by 1.0 kg with glargine. Symptomatic hypoglycemia occurred in 6% on the dual agonist and 23% on glargine (p<0.001), while eGFR slopes did not differ significantly. Gastrointestinal adverse events (nausea 18%, diarrhea 12%) were more common with the dual agonist, generally mild and transient; no pancreatitis or diabetic ketoacidosis was reported. The trial was funded by an academic consortium and was prospectively registered.",
    "subclaim": "Continuous glucose monitoring guided insulin dosing.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "The 0/1-hour troponin I strategy shortened ED stay.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "Discharge rates were higher with the 0/1-hour pathway.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "Thirty-day MACE rates were similar between strategies.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "Thirty-day mortality did not increase.",
    "label": "supported"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "ST-elevation MI patients were included.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "The 0/1-hour algorithm had lower sensitivity than 0/3-hour testing.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "The accelerated strategy increased 30-day MACE.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "Only one hospital participated.",
    "label": "refuted"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "The protocol reduced overall hospital costs.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "Patients over 90 years old were excluded.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "Coronary CT angiography was performed in all low-risk patients.",
    "label": "not_supported"
  },
  {
    "text": "A prospective cohort in three urban emergency departments enrolled 1,200 adults with chest pain and no ST-elevation on ECG. The study compared a 0/1-hour high-sensitivity troponin I algorithm with conventional 0/3-hour serial troponin testing. The primary outcome was emergency department length of stay, with safety endpoints of index myocardial infarction detection and 30-day major adverse cardiac events. Median length of stay was 5.2 hours with the 0/1-hour strategy versus 8.1 hours with the 0/3-hour approach. Sensitivity for index myocardial infarction was 99.5% with the 0/1-hour algorithm and 98.2% with the 0/3-hour strategy, while specificity was 65% and 72%, respectively. The proportion discharged directly from the emergency department was 62% with the 0/1-hour approach versus 41% with the 0/3-hour pathway. Thirty-day major adverse cardiac events were similar at 1.7% and 1.9%, meeting non-inferiority. Subgroup analyses in patients with chronic kidney disease showed preserved safety. There was no increase in 30-day all-cause mortality with the accelerated algorithm.",
    "subclaim": "Women comprised the majority of the cohort.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "The study compared weekly liramacitide with insulin glargine.",
    "label": "supported"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "At 24 weeks, liramacitide reduced HbA1c more than glargine.",
    "label": "supported"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "Liramacitide caused weight loss while glargine caused weight gain.",
    "label": "supported"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "Gastrointestinal adverse events were more common with liramacitide.",
    "label": "supported"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "Adolescents were included in the trial.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "Liramacitide raised systolic blood pressure.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "Liramacitide improved eGFR compared to glargine.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "Pancreatitis occurred in the liramacitide arm.",
    "label": "refuted"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "The average baseline BMI was 32 kg/m2.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "Liramacitide reduced albuminuria.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "Participants were enrolled from Asian centers.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter, open-label trial evaluated weekly liramacitide versus once-daily insulin glargine in adults aged 40–75 with type 2 diabetes and stage 3 chronic kidney disease. All participants continued background oral therapy as tolerated, and outcomes were assessed at 24 weeks. Liramacitide lowered HbA1c by a mean of 1.2%, compared with 0.8% with glargine, favoring liramacitide by 0.4%. Body weight decreased by 3.1 kg on liramacitide but increased by 0.9 kg on glargine. Rates of symptomatic hypoglycemia were 3% with liramacitide and 12% with glargine. Nausea and diarrhea occurred more often with liramacitide (15%) than with glargine (4%). The decline in estimated glomerular filtration rate over 24 weeks was similar between groups. Systolic blood pressure fell modestly with liramacitide (−4 mmHg) versus a smaller change with glargine (−1 mmHg). No pancreatitis, ketoacidosis, or major cardiovascular events were reported in either group.",
    "subclaim": "Continuous glucose monitoring was mandated.",
    "label": "not_supported"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "The trial was double-blind.",
    "label": "supported"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "Empaflozinex lowered the risk of cardiovascular death or heart failure hospitalization.",
    "label": "supported"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "Benefit was observed in patients without diabetes.",
    "label": "supported"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "Genital mycotic infections were more common with empaflozinex.",
    "label": "supported"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "Ejection fraction increased substantially with empaflozinex.",
    "label": "refuted"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "Serum potassium rose with empaflozinex.",
    "label": "refuted"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "Empaflozinex increased severe hypoglycemia.",
    "label": "refuted"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "Only patients with diabetes were enrolled.",
    "label": "refuted"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "The mean baseline eGFR was 60 mL/min/1.73 m2.",
    "label": "not_supported"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "Empaflozinex reduced all-cause mortality as a standalone outcome.",
    "label": "not_supported"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "All participants had implanted ICDs.",
    "label": "not_supported"
  },
  {
    "text": "In a randomized, double-blind, placebo-controlled trial, adults with symptomatic heart failure with reduced ejection fraction (≤35%) received empaflozinex 10 mg daily or placebo. Guideline-directed background therapy, including ACE inhibitors or ARNIs, beta-blockers, and mineralocorticoid antagonists, was maintained when tolerated. Over 12 months, the primary composite of cardiovascular death or heart failure hospitalization occurred in 18% on empaflozinex versus 26% on placebo (hazard ratio 0.68). The treatment effect was consistent in participants with and without type 2 diabetes. Kansas City Cardiomyopathy Questionnaire scores improved by 6 points with empaflozinex versus 2 points with placebo at six months. Left ventricular ejection fraction showed no material change between groups at 12 months. Volume depletion events and genital mycotic infections were more frequent with empaflozinex (6% and 7%) than with placebo (3% and 1%). There was no excess diabetic ketoacidosis or severe hypoglycemia with empaflozinex. Blood pressure fell modestly by about 2 mmHg and serum potassium remained unchanged.",
    "subclaim": "The withdrawal rate due to adverse events was 5%.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "Empagliflozin reduced the composite of HF hospitalization or urgent visit versus placebo.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "Median age was 72 years.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "Genital infections were more common with empagliflozin.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "NT-proBNP fell more with empagliflozin than placebo.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "Participants with eGFR below 30 mL/min/1.73 m^2 were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "Empagliflozin raised systolic blood pressure by 3 mmHg.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "Diabetic ketoacidosis occurred in the empagliflozin arm.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "Women comprised less than 30% of the cohort.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "All-cause mortality was lower with empagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "Quality-of-life scores improved with empagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "Loop diuretic use decreased in the empagliflozin group.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial assessed empagliflozin 10 mg daily versus placebo in 620 adults with heart failure with preserved ejection fraction. The median age was 72 years, and 52% were women. Over 12 months, the primary endpoint of heart failure hospitalization or urgent visit occurred less often with empagliflozin (18%) than with placebo (27%), hazard ratio 0.64. NT-proBNP levels fell by 22% with empagliflozin versus 5% with placebo. Systolic blood pressure decreased by a mean of 3 mmHg in the active group. Rates of diabetic ketoacidosis were zero in both arms, while genital infections were more frequent with empagliflozin (6% vs 2%). Estimated glomerular filtration rate declined similarly in both groups. Patients with systolic blood pressure below 95 mmHg or eGFR under 30 mL/min/1.73 m^2 were excluded. No other major protocol deviations were reported.",
    "subclaim": "The cohort was predominantly White.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "CRP-guided care lowered antibiotic prescribing compared with usual care.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "Thirty-day mortality was 1% in both groups.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "Patients with radiographic pneumonia were excluded.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "The trial enrolled adults with acute COPD exacerbations in primary care.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "The intervention increased 30-day hospital admissions.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "Serious adverse events were more frequent with CRP testing.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "Antibiotics were given to 80% in usual care.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "The algorithm advised antibiotics when CRP was below 20 mg/L.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "Oral corticosteroid use was reduced by CRP guidance.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "Mean FEV1 was 40% predicted.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "Azithromycin was the most common antibiotic.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial in 24 primary care clinics evaluated point-of-care C-reactive protein (CRP) testing for adults with acute COPD exacerbations. A total of 740 patients were assigned to CRP-guided care or usual care. The CRP algorithm discouraged antibiotics at <20 mg/L, suggested consideration at 20-40 mg/L, and supported prescribing at >40 mg/L. Antibiotics were issued at the index visit for 38% of the CRP group and 67% of usual care. Thirty-day hospital admission rates were similar (6% vs 5%), and 30-day mortality was 1% in both groups. Serious adverse events did not differ between arms. Symptom scores at day 7 were comparable. Patients with radiographic pneumonia were excluded, and follow-up lasted 30 days.",
    "subclaim": "Quality-adjusted life years improved over 3 months.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "Adults aged 50–85 were enrolled",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "The trial compared 5 vs 10 days of amoxicillin–clavulanate",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "Day-14 clinical cure with 5 days was noninferior",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "C. difficile infection was lower with the 5-day regimen",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "Immunocompromised patients were included",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "Thirty-day mortality was higher with 5 days",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "Patients received intravenous antibiotics after randomization",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "The study focused on children",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "Macrolide resistance rates were reported",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "Chest imaging clearance at 30 days was measured",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "Smoking status modified outcomes",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled adults aged 50 to 85 hospitalized with uncomplicated community-acquired pneumonia. After initial stabilization, participants received either 5 days or 10 days of oral amoxicillin–clavulanate. The primary outcome, clinical cure at day 14, was noninferior in the 5-day group (86%) compared with the 10-day group (84%). Rates of Clostridioides difficile infection were lower with the shorter course (0% vs 3%). Thirty-day mortality did not differ between groups. Length of stay and readmission rates were similar. Immunocompromised patients and those with suspected viral pneumonia were excluded. No intravenous antibiotics were given after randomization.",
    "subclaim": "The trial was industry-funded",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "ST-elevation cases were excluded for emergent PCI",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "The 0/1-hour algorithm increased early discharge within 2 hours",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "Thirty-day MI or death did not increase",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "ED length of stay dropped by about 90 minutes",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "The study took place in a rural emergency department",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "Patients with renal failure were excluded",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "Inpatient stress testing increased after the change",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "A 3-hour troponin protocol replaced a 0/1-hour one",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "Aspirin prescribing at discharge increased",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "The protocol reduced per-visit costs",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "Women were discharged less often than men",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a high-sensitivity troponin 0/1-hour algorithm for adults with suspected non–ST-elevation myocardial infarction. Patients with new ST elevation were excluded and sent for emergent PCI per protocol. Compared with the prior 3-hour protocol, the new approach increased early discharge within 2 hours (38% vs 12%). There was no increase in 30-day myocardial infarction or death after discharge. The algorithm incorporated ECG assessment and a clinical risk score. Renal failure alone was not a contraindication; a delta troponin threshold was applied. Median emergency department length of stay decreased by about 90 minutes. The change did not alter the proportion of patients receiving inpatient stress testing.",
    "subclaim": "The troponin assay vendor was Roche",
    "label": "not_supported"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Semaglutide lowered HbA1c more than glargine.",
    "label": "supported"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Weight fell in the semaglutide group.",
    "label": "supported"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Hypoglycemia was less common with semaglutide.",
    "label": "supported"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Nausea was more frequent with semaglutide.",
    "label": "supported"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "The trial lasted 52 weeks.",
    "label": "refuted"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Severe hypoglycemia was frequent in both groups.",
    "label": "refuted"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Blood pressure improved with semaglutide.",
    "label": "refuted"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Participants were adolescents.",
    "label": "refuted"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Retinopathy events increased with semaglutide.",
    "label": "not_supported"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Patients with cardiovascular disease were excluded.",
    "label": "not_supported"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Therapy was combined with sitagliptin.",
    "label": "not_supported"
  },
  {
    "text": "In a 24-week randomized open-label trial at three centers, 312 adults with type 2 diabetes on metformin were assigned to once-weekly semaglutide (0.5–1.0 mg) or nightly insulin glargine titrated to fasting glucose 80–110 mg/dL. Participants were overweight (mean BMI 33), baseline HbA1c 8.6%, and mean age 56 years. The primary outcome was change in HbA1c at week 24. Semaglutide reduced HbA1c by 1.6% versus 1.1% with glargine (p<0.001). Mean body weight decreased by 4.8 kg with semaglutide but increased by 1.2 kg with glargine. Symptomatic hypoglycemia occurred in 6% on semaglutide versus 19% on glargine. Nausea was more frequent with semaglutide (18% vs 4%). eGFR and blood pressure were unchanged in both groups. No pancreatitis or severe hypoglycemia was reported.",
    "subclaim": "Treatment cost favored glargine.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "A 0/1-hour hs-troponin I algorithm was used.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "Over half were discharged directly from the ED.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "Sensitivity for index MI exceeded 98%.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "Admission rates fell after implementation.",
    "label": "supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "The algorithm increased 30-day cardiac returns.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "Specificity was below 50%.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "Only patients without coronary disease were enrolled.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "Point-of-care ultrasound was mandated by the pathway.",
    "label": "refuted"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "Beta-blocker initiation was recommended at discharge.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "Median initial troponin was 12 ng/L.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "ECG changes were required for rule-in.",
    "label": "not_supported"
  },
  {
    "text": "A prospective implementation study evaluated a 0/1-hour high-sensitivity troponin I algorithm in 1,084 adults presenting with chest pain to two urban emergency departments. Median age was 58 years, 41% were female, and 22% had known coronary disease. Patients were stratified into rule-out, observe, or rule-in arms based on baseline and 1-hour troponin changes. The algorithm discharged 54% directly from the ED with outpatient follow-up. At 30 days, the negative predictive value for myocardial infarction or cardiac death in the rule-out arm was 99.6% (95% CI 98.7–99.9). Sensitivity for index myocardial infarction was 98.9%, while specificity was 74%. Admission rates decreased by 12% compared with the pre-implementation period. No increase in 30-day returns for cardiac causes was observed. Use of point-of-care ultrasound was not part of the pathway.",
    "subclaim": "Thirty-day mortality was 0.2%.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "The trial enrolled adults with type 1 diabetes.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "CGM plus self-monitoring was compared with self-monitoring alone.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "CGM reduced HbA1c more than control.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "No diabetic ketoacidosis occurred.",
    "label": "supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "Children were enrolled in the trial.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "Time below 54 mg/dL increased in the CGM arm.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "Blood pressure fell significantly in the CGM group.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "Severe skin reactions were common with CGM.",
    "label": "refuted"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "Quality of life improved with CGM.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "Baseline HbA1c was higher in the CGM arm.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "The sensors were factory-calibrated.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter randomized trial enrolled 220 adults with type 1 diabetes using multiple daily injections. Participants were assigned to real-time continuous glucose monitoring (CGM) plus self-monitoring of blood glucose or to self-monitoring alone for 24 weeks. Mean baseline HbA1c was approximately 8.4% across the cohort. At 24 weeks, the CGM group lowered HbA1c by 0.9% versus 0.2% in controls, a between-group difference of −0.7% (95% CI −0.9 to −0.5). Time spent below 54 mg/dL decreased by 30% in the CGM arm but rose by 5% in the control arm. Severe hypoglycemia events were fewer with CGM (3 events) than with control (9 events). There were no episodes of diabetic ketoacidosis and no significant changes in estimated glomerular filtration rate or blood pressure in either group. Median device wear in the CGM arm was 6.3 days per week. Mild skin irritation occurred in 12% of CGM users, and no device-related serious adverse events were reported.",
    "subclaim": "Patients with proliferative retinopathy were excluded.",
    "label": "not_supported"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "Age-adjusted D-dimer reduced CTPA use compared with a fixed cutoff.",
    "label": "supported"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "The 3-month VTE rate after a negative workup was 0.3%.",
    "label": "supported"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "Pregnant patients were excluded.",
    "label": "supported"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "No anaphylaxis was reported.",
    "label": "supported"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "All participants underwent CTPA.",
    "label": "refuted"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "The strategy increased missed pulmonary emboli compared to conventional thresholds.",
    "label": "refuted"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "The study enrolled only children.",
    "label": "refuted"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "Pregnant patients were included.",
    "label": "refuted"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "Median age was 68 years.",
    "label": "not_supported"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "A high-sensitivity ELISA D-dimer assay was used.",
    "label": "not_supported"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "Most participants had previous venous thromboembolism.",
    "label": "not_supported"
  },
  {
    "text": "In an emergency department study, 1,000 adults with suspected pulmonary embolism underwent evaluation using Wells score and an age-adjusted D-dimer threshold. Patients with a Wells score of 4 or less and a D-dimer below age×10 ng/mL (FEU) were not imaged, while others proceeded to computed tomography pulmonary angiography (CTPA). Compared with a historical fixed D-dimer cutoff strategy, age-adjustment reduced CTPA use from 42% to 30%. Among those managed without imaging, the 3-month rate of venous thromboembolism was 0.3%, meeting a non-inferiority margin versus the conventional strategy (0.4%). Cancer patients had a slightly higher failure rate of 0.8%, but no pulmonary embolism–related deaths occurred. Pregnant patients were excluded from enrollment, and pediatric patients were not studied. Contrast-related acute kidney injury occurred in one scanned patient; no cases of anaphylaxis were reported. The study did not mandate routine follow-up imaging; outcomes were ascertained by clinic visits and record review.",
    "subclaim": "The study was conducted at three urban hospitals.",
    "label": "not_supported"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "Dapagliflozin was added to metformin for 24 weeks.",
    "label": "supported"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "eGFR decline was slower with dapagliflozin than control.",
    "label": "supported"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "Heart failure hospitalizations were fewer with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "No diabetic ketoacidosis cases occurred.",
    "label": "supported"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "The study enrolled patients with type 1 diabetes.",
    "label": "refuted"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "Systolic blood pressure increased with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "Severe hypoglycemia was higher with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "Metformin was discontinued at randomization.",
    "label": "refuted"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "Urinary tract infection rates increased with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "Twenty percent of participants were Asian.",
    "label": "not_supported"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "Diabetic retinopathy progression was reduced.",
    "label": "not_supported"
  },
  {
    "text": "A single-center, open-label trial enrolled 184 adults with type 2 diabetes and stage 3 chronic kidney disease (eGFR 30–59 mL/min/1.73 m²). Participants continued metformin and were randomized to add dapagliflozin 10 mg daily or no additional agent for 24 weeks. Baseline HbA1c averaged 8.3%, and insulin doses, when present, were kept stable. Compared with control, the dapagliflozin group had a slower decline in eGFR (−0.8 vs −3.1 mL/min/1.73 m²). Hospitalizations for heart failure occurred in 1/92 in the dapagliflozin arm versus 6/92 in control. Mild genital mycotic infections were more frequent with dapagliflozin, while severe hypoglycemia was rare and similar between groups. No cases of diabetic ketoacidosis were observed. Systolic blood pressure decreased by a median of 3 mm Hg in the dapagliflozin arm. Retinal outcomes and neuropathy were not assessed.",
    "subclaim": "HbA1c fell by 1% with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "Pregnant patients were excluded.",
    "label": "supported"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "CTPA use decreased with the new strategy.",
    "label": "supported"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "Positive CTPA yield increased.",
    "label": "supported"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "No PE-related deaths occurred within 30 days.",
    "label": "supported"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "This was a randomized controlled trial.",
    "label": "refuted"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "Emergency department length of stay increased.",
    "label": "refuted"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "The largest reduction in imaging was in patients under 30 years.",
    "label": "refuted"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "Hemodynamically unstable patients were included.",
    "label": "refuted"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "Contrast-induced nephropathy occurred in 2% of imaged patients.",
    "label": "not_supported"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "More than 25% of participants had active cancer.",
    "label": "not_supported"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "The average D-dimer value was 650 ng/mL.",
    "label": "not_supported"
  },
  {
    "text": "Three urban emergency departments implemented an age-adjusted D-dimer strategy combined with the YEARS criteria for suspected pulmonary embolism. Over 12 months, 1,103 adults were enrolled; pregnant and hemodynamically unstable patients were excluded. This was a prospective implementation study, not a randomized trial. Compared with the prior fixed 500 ng/mL threshold, the new approach reduced CTPA use from 28% to 19%, with the largest reduction among patients older than 70 years. The yield of positive CTPA increased from 11% to 15%. Median emergency department length of stay decreased by 36 minutes. Anticoagulation was initiated without imaging in high-probability cases per protocol, sometimes guided by leg ultrasound. At 30 days, symptomatic venous thromboembolism after discharge occurred in 0.6%, with no PE-related deaths. Rates of missed isolated subsegmental PE did not increase.",
    "subclaim": "PERC rule performance was analyzed.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "Semaglutide reduced HbA1c more than glipizide.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "Participants were adults on metformin.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "Weight increased with glipizide.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "Hypoglycemia was more common with glipizide.",
    "label": "supported"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "The trial lasted 52 weeks.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "Patients with eGFR 20 mL/min/1.73 m2 were included.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "Blood pressure rose notably with semaglutide.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "Several pancreatitis cases occurred.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "Semaglutide increased retinopathy events.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "The sample size was 600.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic randomized trial compared weekly semaglutide with daily glipizide in adults with type 2 diabetes inadequately controlled on metformin. The 24-week study enrolled participants with a mean BMI of 34 kg/m2 and excluded those with an eGFR below 30 mL/min/1.73 m2. Semaglutide achieved greater HbA1c reduction than glipizide by week 24. Body weight decreased with semaglutide but increased slightly with glipizide. Symptomatic hypoglycemia occurred more often in the glipizide group. Transient nausea was reported early with semaglutide and generally resolved by week 8. Clinic blood pressure did not change meaningfully in either arm. No pancreatitis cases were observed in either group.",
    "subclaim": "Median diabetes duration was 10 years.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "Dapagliflozin lowered heart failure hospitalization risk.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "Non-diabetic patients were included.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "The study was double-blind.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "Genital infections were more common with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "Type 1 diabetes patients were enrolled.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "Systolic blood pressure increased with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "Acute kidney injury was more frequent with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "eGFR fell progressively throughout treatment.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "Mean age was 67 years.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "All participants had ischemic cardiomyopathy.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "Quality-of-life scores improved with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter, double-blind trial, adults with heart failure with reduced ejection fraction (LVEF <=40%) were randomized to dapagliflozin or placebo on top of standard therapy. Most participants had NYHA class II-III symptoms, and both patients with and without diabetes were eligible. The median follow-up was 18 months. Dapagliflozin reduced the composite of cardiovascular death or heart failure hospitalization compared with placebo. The rate of heart failure hospitalization was lower with dapagliflozin. Systolic blood pressure decreased modestly, by about 3 mmHg, without excess acute kidney injury. A transient dip in eGFR was observed early with dapagliflozin, followed by stabilization. Genital mycotic infections were more frequent with dapagliflozin but were mostly mild. Patients with type 1 diabetes or an eGFR below 25 mL/min/1.73 m2 were excluded.",
    "subclaim": "Atrial fibrillation at baseline was required.",
    "label": "not_supported"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "The trial used budesonide-formoterol as SMART.",
    "label": "supported"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "Severe exacerbations were 30% lower with SMART.",
    "label": "supported"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "Nighttime awakenings were fewer with SMART.",
    "label": "supported"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "Oral candidiasis occurred in 3% of SMART patients.",
    "label": "supported"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "Rescue albuterol use was higher in the SMART arm.",
    "label": "refuted"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "Pneumonia was more common with SMART.",
    "label": "refuted"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "No tremor occurred in either group.",
    "label": "refuted"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "The study lasted only 12 weeks.",
    "label": "refuted"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "FeNO decreased more with SMART.",
    "label": "not_supported"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "Baseline eosinophils were used to stratify response.",
    "label": "not_supported"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "Current smokers were excluded from enrollment.",
    "label": "not_supported"
  },
  {
    "text": "At 10 community clinics, a randomized open-label trial enrolled 312 adults aged 18–65 with moderate persistent asthma. Participants were assigned to budesonide-formoterol used both as maintenance and reliever (SMART strategy) or to fixed-dose fluticasone-salmeterol with albuterol as needed. Over 24 weeks, the SMART group had a 30% lower rate of severe exacerbations requiring oral prednisone (rate ratio 0.70, 95% CI 0.55–0.90). Pre-bronchodilator FEV1 increased by a mean of 150 mL in the SMART group versus 60 mL with the comparator. Nighttime awakenings decreased more with SMART (median 1 vs 3 per month). Rescue albuterol use was lower in the SMART arm. Rates of pneumonia were similar between groups, while oral candidiasis occurred in 3% with SMART and 4% with comparator. Mild tremor was reported by 5% in both arms, and no treatment-related hospitalizations occurred.",
    "subclaim": "SMART improved asthma quality-of-life scores.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "A 0/1-hour hs-troponin T algorithm was implemented.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "Fifty-five percent met rule-out at 1 hour.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "Sensitivity was 98.8% for MI within 30 days.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "Length of stay fell by 2.1 hours.",
    "label": "supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "Rule-in occurred in 5% of patients.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "The algorithm reduced the rate of invasive angiography.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "NPV for MI was about 90%.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "Sensitivity dropped below 90% in patients with eGFR <60.",
    "label": "refuted"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "The study was randomized.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "Outpatient cardiology follow-up within 72 hours increased.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "Women had lower rule-out proportions than men.",
    "label": "not_supported"
  },
  {
    "text": "An urban emergency department implemented a 0/1-hour high-sensitivity troponin T algorithm for adults presenting with possible acute coronary syndrome. Among 1,024 consecutive patients, 55% met rule-out criteria at 1 hour and were discharged with rapid follow-up. The algorithm showed 98.8% sensitivity and 99.6% negative predictive value for index myocardial infarction within 30 days. Rule-in occurred in 16%, with a specificity of 91%. Median length of stay decreased by 2.1 hours compared with the prior standard-of-care cohort. No deaths were attributed to missed myocardial infarction in the rule-out group. In patients with eGFR below 60 mL/min/1.73 m2, specificity was lower but sensitivity remained above 98%. Implementation did not change the rate of invasive coronary angiography overall.",
    "subclaim": "Sex-specific troponin thresholds were used.",
    "label": "not_supported"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "Adults with type 2 diabetes and chronic kidney disease were randomized.",
    "label": "supported"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "eGFR decline was slower with the SGLT2 inhibitor than placebo.",
    "label": "supported"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "Heart failure hospitalizations were reduced in the active arm.",
    "label": "supported"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "Genital mycotic infections were more frequent with the drug.",
    "label": "supported"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "The trial enrolled only Asian centers.",
    "label": "refuted"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "The intervention raised systolic blood pressure.",
    "label": "refuted"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "Acute kidney injury was more common with the SGLT2 inhibitor.",
    "label": "refuted"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "The mean participant age was under 40 years.",
    "label": "refuted"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "The drug reduced diabetic retinopathy progression.",
    "label": "not_supported"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "HbA1c decreased by 1% more than placebo.",
    "label": "not_supported"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "Bone fracture risk increased with therapy.",
    "label": "not_supported"
  },
  {
    "text": "In a double-blind randomized trial at 52 centers in North America and Europe, 780 adults with type 2 diabetes and chronic kidney disease (eGFR 25–60 mL/min/1.73 m2) received either an SGLT2 inhibitor or placebo for 24 months. The mean age was 63 years and 42% were women. The primary endpoint, annual eGFR slope, declined less with the SGLT2 inhibitor, with a between-group difference of 1.8 mL/min/1.73 m2 per year. Hospitalization for heart failure occurred less often in the active arm, a 30% relative reduction versus placebo. Systolic blood pressure fell by 5 mm Hg with the drug and by 1 mm Hg with placebo. Acute kidney injury occurred in 8% on the drug versus 12% on placebo. Genital mycotic infections were more frequent with the SGLT2 inhibitor (9% vs 3%). Rates of hyperkalemia and ketoacidosis did not differ between groups. Follow-up adherence exceeded 90% in both arms.",
    "subclaim": "The study used an event-driven design.",
    "label": "not_supported"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "An ultrasound-first protocol was used for suspected appendicitis.",
    "label": "supported"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "Radiation exposure decreased by about a third.",
    "label": "supported"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "The negative appendectomy rate dropped after protocol adoption.",
    "label": "supported"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "Ultrasound sensitivity was higher in children than adults.",
    "label": "supported"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "All patients underwent immediate CT scanning.",
    "label": "refuted"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "Only patients older than 50 were included.",
    "label": "refuted"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "Perforation rate increased under the protocol.",
    "label": "refuted"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "Ultrasound sensitivity was lower in children than adults.",
    "label": "refuted"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "Contrast-induced nephropathy decreased with the protocol.",
    "label": "not_supported"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "Imaging costs per case increased.",
    "label": "not_supported"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "MRI replaced CT for pregnant patients.",
    "label": "not_supported"
  },
  {
    "text": "As part of an emergency department quality initiative at an urban academic hospital, 1,200 patients aged 8 to 70 years with suspected appendicitis were managed with an ultrasound-first imaging protocol. Ultrasound was the initial test in 60% of cases, with CT reserved for equivocal or non-diagnostic studies. Overall diagnostic performance of ultrasound showed 91% sensitivity and 94% specificity. In children, sensitivity reached 95%, compared with 88% in adults. Radiation exposure per patient decreased by 35% relative to the prior CT-first approach. The negative appendectomy rate fell from 7% to 4% after protocol adoption. Median emergency department length of stay increased by 20 minutes in the ultrasound-first pathway due to additional imaging in some patients. The rate of perforated appendicitis was unchanged, and no increase in missed appendicitis was observed within 30 days.",
    "subclaim": "Radiologist interobserver agreement exceeded kappa 0.8.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "The study randomized patients to tenecteplase or alteplase.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "Anticoagulated patients were excluded.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "Tenecteplase increased pre-thrombectomy reperfusion rates.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "Symptomatic intracranial hemorrhage rates were similar between groups.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "Most strokes were in the posterior circulation.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "Tenecteplase reduced 90-day mortality.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "Door-to-needle times were longer with tenecteplase.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "The study was observational without randomization.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "Tenecteplase dose was 0.25 mg/kg.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "Functional independence at 90 days was higher with tenecteplase.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "General anesthesia use was more common in the alteplase arm.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults aged 18 to 85 with anterior circulation large-vessel occlusion presenting within 4.5 hours were assigned to tenecteplase or alteplase before planned thrombectomy. Patients receiving therapeutic anticoagulation were excluded. Tenecteplase led to a higher rate of substantial reperfusion on the initial catheter angiogram before any thrombectomy maneuvers compared with alteplase. Symptomatic intracranial hemorrhage occurred at similar frequencies in both groups. Median door-to-needle times were comparable between arms across sites. Ninety-day mortality did not differ between the treatments. Most enrolled strokes involved the middle cerebral artery rather than the posterior circulation. The trial used concealed allocation with blinded imaging adjudication.",
    "subclaim": "Median onset-to-needle time exceeded 3 hours.",
    "label": "not_supported"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "Triple therapy reduced exacerbations compared to dual therapy.",
    "label": "supported"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "Benefit was larger at eosinophils ≥300 cells/µL.",
    "label": "supported"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "Pneumonia events were more frequent with triple therapy.",
    "label": "supported"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "All-cause mortality did not differ between arms.",
    "label": "supported"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "The study was double-blind.",
    "label": "refuted"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "All participants were nonsmokers.",
    "label": "refuted"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "Triple therapy markedly improved FEV1 vs dual therapy.",
    "label": "refuted"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "Recent pneumonia was required for inclusion.",
    "label": "refuted"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "Average BMI was 24 kg/m2.",
    "label": "not_supported"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "Inhaler technique training was provided at baseline.",
    "label": "not_supported"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "Exacerbation reductions were driven by fewer hospitalizations.",
    "label": "not_supported"
  },
  {
    "text": "In a pragmatic open-label study across primary care clinics, adults with COPD and at least one moderate or severe exacerbation in the prior year were assigned to start triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA). Participants had a mean age of 66 years, and active smoking was common. Over 12 months, annualized moderate-to-severe exacerbation rates were lower with triple therapy than with dual therapy. The reduction was more pronounced among patients with blood eosinophil counts of 300 cells/µL or higher. Mean trough FEV1 improved modestly in both groups without a clinically meaningful between-group difference. Pneumonia events occurred more often in the triple therapy arm. All-cause mortality did not differ between arms. Patients with a recent pneumonia were excluded from enrollment. Medication adherence exceeded 80% in each arm.",
    "subclaim": "The ICS component was fluticasone furoate.",
    "label": "not_supported"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "Adults with T2D and NAFLD aged 30–75 were randomized.",
    "label": "supported"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "Semaglutide reduced liver fat more than metformin at 48 weeks.",
    "label": "supported"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "HbA1c fell more with semaglutide than with metformin.",
    "label": "supported"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "No severe hypoglycemia occurred in either arm.",
    "label": "supported"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "Adolescents were included in the trial.",
    "label": "refuted"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "Participants with eGFR below 45 mL/min/1.73 m² were enrolled.",
    "label": "refuted"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "The primary endpoint was blood pressure change.",
    "label": "refuted"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "Pancreatitis occurred in the semaglutide group.",
    "label": "refuted"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "The trial was funded by a government grant.",
    "label": "not_supported"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "Semaglutide improved liver fibrosis stage on biopsy.",
    "label": "not_supported"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "Metformin caused alopecia.",
    "label": "not_supported"
  },
  {
    "text": "In a 48-week, multicenter randomized trial, 284 adults aged 30–75 with newly diagnosed type 2 diabetes and ultrasound-confirmed nonalcoholic fatty liver disease were assigned to once-weekly semaglutide or standard-dose metformin. Key exclusions included estimated GFR below 45 mL/min/1.73 m² and prior GLP-1 receptor agonist use. The primary endpoint was relative change in liver fat by MRI-PDFF at week 48, with HbA1c and ALT as secondary outcomes. Semaglutide produced greater liver fat reduction than metformin (−34% vs −18% relative), accompanied by larger HbA1c declines (−1.6% vs −1.0%). Weight loss favored semaglutide, while office blood pressure remained unchanged in both groups. Gastrointestinal adverse events, mainly nausea and diarrhea, were more frequent with semaglutide, but no pancreatitis occurred. No severe hypoglycemia was reported in either arm, and statin co-therapy was permitted if stable for 3 months. Retinopathy events were uncommon and similar between groups.",
    "subclaim": "Most participants were of Asian ethnicity.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "The cohort included 312 adolescents aged 12–17.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "Endoscopy with histology was the reference standard.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "At 50 µg/g, fecal calprotectin sensitivity for IBD was 92%.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "Raising the fecal calprotectin threshold to 100 µg/g increased specificity.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "Adults over 30 were enrolled.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "Abdominal MRI was performed for all participants.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "Fecal calprotectin had 50% sensitivity at the 50 µg/g threshold.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "Several cases of celiac disease were diagnosed.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "Point-of-care fecal calprotectin testing was used.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "The cost per fecal calprotectin test was under $20.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "Stool sampling was repeated after treatment.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective multicenter study of 312 adolescents (12–17 years) with chronic abdominal pain and diarrhea to evaluate fecal calprotectin for detecting inflammatory bowel disease. All participants underwent endoscopy with histology, which served as the reference standard. No abdominal MRI was performed as part of the protocol. Using a threshold of 50 µg/g, fecal calprotectin yielded 92% sensitivity and 74% specificity for IBD, with a negative predictive value of 97%. Increasing the threshold to 100 µg/g raised specificity to 86% but reduced sensitivity to 84%. C-reactive protein was elevated in 60% of confirmed IBD cases, and NSAID use was recorded as a potential confounder. Fecal calprotectin levels did not correlate with endoscopic severity scores. All participants had negative celiac serology, and no cases of celiac disease were identified.",
    "subclaim": "General anesthesia was used for endoscopy.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "Triple therapy reduced annualized moderate/severe exacerbations.",
    "label": "supported"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "The trial lasted 52 weeks.",
    "label": "supported"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "Pneumonia was more frequent with triple therapy than with dual therapy.",
    "label": "supported"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "All-cause mortality did not differ between groups.",
    "label": "supported"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "Dual bronchodilator therapy improved FEV1 more than triple therapy.",
    "label": "refuted"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "Dyspnea scores improved more with triple therapy.",
    "label": "refuted"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "The study enrolled fewer than 200 patients.",
    "label": "refuted"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "Exacerbation benefits were limited to never-smokers.",
    "label": "refuted"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "Triple therapy reduced hospital length of stay.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "Blood eosinophils predicted who benefited most.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "Adherence was higher in the dual therapy group.",
    "label": "not_supported"
  },
  {
    "text": "A multicenter trial enrolled 720 adults with moderate-to-severe COPD. Participants were randomized to once-daily inhaled triple therapy (ICS/LABA/LAMA) or dual bronchodilator (LABA/LAMA) for 52 weeks. The primary endpoint, annualized moderate/severe exacerbations, was 22% lower with triple therapy. Pre-bronchodilator FEV1 improved by a mean of 90 mL at week 24 in the triple arm versus 30 mL with dual therapy. Dyspnea (mMRC) scores decreased similarly in both groups. Radiologically confirmed pneumonia occurred in 5% on triple therapy and 3% on dual therapy. All-cause mortality did not differ between groups. Benefits on exacerbation reduction were consistent in current and former smokers.",
    "subclaim": "SGRQ quality-of-life scores improved more with dual therapy.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "Procalcitonin guidance reduced antibiotic duration.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "There was no difference in 28-day mortality.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "C. difficile infection was less frequent with guidance.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "Stopping antibiotics was advised after an 80% procalcitonin decline.",
    "label": "supported"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "The trial included only ICU patients.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "Guidance increased antibiotic use compared with usual care.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "Mortality was lower with procalcitonin guidance.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "Effects differed markedly in chronic kidney disease patients.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "Ninety-day readmissions were reduced by guidance.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "Baseline lactate was higher in the guidance group.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "Antibiotic adverse reactions were more common with usual care.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic trial in 12 hospitals enrolled 1,050 adults with suspected bacterial sepsis. Clinicians in the intervention arm used a procalcitonin-guided algorithm for starting and stopping antibiotics; controls received usual care. Median antibiotic duration by day 28 was 7 days with guidance versus 10 days with usual care. There was no difference in 28-day mortality. ICU length of stay was one day shorter with guidance. Clostridioides difficile infection occurred in 1.5% with guidance and 3.2% with usual care. The algorithm recommended withholding antibiotics when procalcitonin was below 0.25 µg/L and stopping when levels fell by 80%. Effects were similar in patients with chronic kidney disease.",
    "subclaim": "Time to first antibiotic dose was delayed by the algorithm.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Dapagliflozin slowed eGFR decline versus placebo.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Albuminuria decreased with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Genital mycotic infections were more common with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "People with type 1 diabetes were excluded.",
    "label": "supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "The trial lasted 24 months.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Mean age was 72 years.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "All participants were women.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Dapagliflozin increased diabetic ketoacidosis.",
    "label": "refuted"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "The trial was double-blind.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Dapagliflozin reduced stroke risk.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Mean diabetes duration was 10 years.",
    "label": "not_supported"
  },
  {
    "text": "In a multicenter randomized trial, adults with type 2 diabetes and stage 3 chronic kidney disease were assigned to dapagliflozin 10 mg daily or placebo. Background renin-angiotensin blockade was required for enrollment. Over 12 months, the annual eGFR decline was -1.6 mL/min/1.73 m2 per year with dapagliflozin versus -3.2 with placebo. Urine albumin-to-creatinine ratio fell by 28% in the dapagliflozin group relative to placebo. Hospitalizations for heart failure occurred in 3% with dapagliflozin and 6% with placebo. Hemoglobin A1c decreased modestly by 0.3% and systolic blood pressure by 4 mmHg with dapagliflozin. Genital mycotic infections were more frequent with dapagliflozin (8% vs 2%), while diabetic ketoacidosis and hyperkalemia rates were similar between groups. Symptoms of volume depletion were slightly more common with dapagliflozin. The 480 participants had a mean age of 62 years, 40% were women, and 25% identified as Black; those with type 1 diabetes or eGFR below 30 were excluded.",
    "subclaim": "Hypoglycemia was more frequent with dapagliflozin.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "About half of patients were ruled out by the algorithm.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "Sensitivity for index MI was at least 99%.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "No deaths occurred in the rule-out group at 30 days.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "ED stay was shorter than with a 3-hour protocol.",
    "label": "supported"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "Only women were enrolled.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "The algorithm used a 0/3-hour sampling schedule.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "Renal impairment caused the algorithm to fail in all cases.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "A risk score was mandatory for enrollment.",
    "label": "refuted"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "The study was randomized.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "Median time from symptom onset was under 3 hours.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "The algorithm reduced 30-day revascularization.",
    "label": "not_supported"
  },
  {
    "text": "We conducted a prospective emergency department study of a high-sensitivity cardiac troponin I 0/1-hour algorithm in adults presenting with possible acute coronary syndrome. The cohort included 1,200 patients, 54% male, with a median age of 58 years. Troponin was measured at arrival and 1 hour using predefined rule-out, observation, and rule-in thresholds. The algorithm ruled out myocardial infarction in 52% of patients with a sensitivity of 99.2% and a negative predictive value of 99.6% for index MI. Among those ruled out, 30-day major adverse cardiac events occurred in 0.4%, and there were no deaths. Compared to a matched historical 3-hour protocol, emergency department length of stay was shortened by 1.8 hours. Patients with estimated glomerular filtration rate below 45 mL/min had more indeterminate results, but overall performance remained high. Accuracy was similar in men and women. Use of the HEART score was permitted but not required, and antiplatelet prescribing was left to treating clinicians.",
    "subclaim": "Per-patient costs were lower with the algorithm.",
    "label": "not_supported"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "Participants had type 2 diabetes on metformin.",
    "label": "supported"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "Semaglutide lowered HbA1c more than glargine.",
    "label": "supported"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "Weight decreased with semaglutide and increased with glargine.",
    "label": "supported"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "Hypoglycemia was less frequent with semaglutide.",
    "label": "supported"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "The trial followed patients for 12 months.",
    "label": "refuted"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "All participants had type 1 diabetes.",
    "label": "refuted"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "Gastrointestinal events were more common with glargine.",
    "label": "refuted"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "Serious adverse events were higher with semaglutide.",
    "label": "refuted"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "Baseline mean BMI was 35 kg/m2.",
    "label": "not_supported"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "Systolic blood pressure fell in both groups.",
    "label": "not_supported"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "Retinopathy events increased with semaglutide.",
    "label": "not_supported"
  },
  {
    "text": "Adults with type 2 diabetes inadequately controlled on metformin were randomized to once-weekly semaglutide 1.0 mg or titrated nightly insulin glargine for 32 weeks. The primary endpoint was change in HbA1c, with semaglutide lowering HbA1c by 1.8% versus 1.2% with glargine. More patients on semaglutide achieved HbA1c below 7%. Body weight decreased by 4.5 kg with semaglutide but increased by 1.2 kg with glargine. Confirmed hypoglycemia was less frequent with semaglutide than with glargine. Nausea and vomiting were the most common adverse events in the semaglutide arm and led to more discontinuations. Serious adverse event rates were similar between groups. Patients with type 1 diabetes or eGFR below 30 mL/min/1.73 m2 were excluded.",
    "subclaim": "Asian participants comprised 40%.",
    "label": "not_supported"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "The study enrolled pregnant patients with suspected appendicitis.",
    "label": "supported"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "MRI had higher sensitivity than ultrasound.",
    "label": "supported"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "No gadolinium was used.",
    "label": "supported"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "MRI took longer to achieve a diagnosis.",
    "label": "supported"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "CT was the primary imaging modality.",
    "label": "refuted"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "Ultrasound had higher specificity than MRI.",
    "label": "refuted"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "Imaging results were not verified against any reference standard.",
    "label": "refuted"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "The study reported contrast-related adverse events.",
    "label": "refuted"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "MRI reduced length of hospital stay.",
    "label": "not_supported"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "Fetal outcomes improved with MRI.",
    "label": "not_supported"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "MRI cost less than ultrasound.",
    "label": "not_supported"
  },
  {
    "text": "At a tertiary center, 210 pregnant patients with suspected appendicitis underwent ultrasound followed by non-contrast MRI. The reference standard was surgical and pathology confirmation when operated, and clinical follow-up otherwise. MRI showed higher sensitivity (94%) and specificity (97%) than ultrasound (68% and 90%). Time to diagnosis was about 40 minutes longer with MRI due to scanner availability. No gadolinium contrast was used, and no imaging-related adverse events were reported. Imaging with MRI avoided ionizing radiation. Prior appendectomy was an exclusion criterion. The study was prospective and included patients across all trimesters.",
    "subclaim": "Inter-reader agreement exceeded 0.9.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Adults with type 2 diabetes and stage 3 CKD were randomized.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Dapagliflozin slowed eGFR decline versus placebo.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Heart failure hospitalization was reduced with dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Genital mycotic infections were more common on dapagliflozin.",
    "label": "supported"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Children were enrolled in the trial.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Dapagliflozin increased hyperkalemia risk.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Stroke was reduced by dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Urinary tract infections were higher with dapagliflozin.",
    "label": "refuted"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Dapagliflozin lowered HbA1c compared with placebo.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "All participants received ACE inhibitors.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Dapagliflozin reduced diabetic retinopathy progression.",
    "label": "not_supported"
  },
  {
    "text": "A double-blind randomized trial across 22 centers evaluated dapagliflozin in adults with type 2 diabetes and stage 3 chronic kidney disease. A total of 812 patients aged 40–75 with eGFR 30–59 ml/min/1.73m2 and albuminuria were assigned to dapagliflozin 10 mg daily or placebo for 18 months. The primary endpoint was annual eGFR slope, with secondary outcomes including hospitalization for heart failure, stroke, and safety events. Dapagliflozin slowed eGFR decline by 1.2 ml/min/1.73m2 per year compared with placebo. Hospitalization for heart failure was reduced by 28% in the dapagliflozin group. Stroke incidence did not differ between groups. Genital mycotic infections were more common with dapagliflozin, while urinary tract infection rates were similar. Hyperkalemia was not increased, and mild volume depletion occurred in 6% versus 3% with placebo. No pediatric participants were enrolled.",
    "subclaim": "Mean BMI exceeded 35 kg/m2.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "The 0/1-hour troponin strategy shortened emergency department stay.",
    "label": "supported"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "Thirty-day MI or death rates were similar between groups.",
    "label": "supported"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "Direct discharge from the ED increased with the accelerated pathway.",
    "label": "supported"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "Outpatient cardiology referrals were higher in the accelerated arm.",
    "label": "supported"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "Seven-day return visits increased with the 0/1-hour strategy.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "Only one emergency department participated.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "The accelerated algorithm required more ED imaging or catheterization.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "Nonagenarians were routinely enrolled.",
    "label": "refuted"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "The accelerated pathway reduced in-hospital mortality.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "Women comprised over 60% of participants.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "Hospital costs decreased with the 0/1-hour strategy.",
    "label": "not_supported"
  },
  {
    "text": "A pragmatic cluster-randomized trial in 12 emergency departments tested a 0/1-hour high-sensitivity troponin algorithm for suspected acute coronary syndrome. In total, 9,430 adults with chest pain were managed with either the new algorithm or the standard 0/3-hour protocol over 10 months. The primary outcome was ED length of stay, with safety endpoints including 30-day myocardial infarction or death and 7-day return visits. The 0/1-hour strategy shortened median length of stay by 1.8 hours and increased direct discharge from the ED. Rates of 30-day myocardial infarction or death were similar between strategies. Seven-day return visits did not increase with the 0/1-hour pathway. More patients were referred for outpatient cardiology within two weeks in the accelerated arm. Implementation did not require additional imaging or catheterization in the ED. Few patients were older than 85, and most sites excluded nonagenarians.",
    "subclaim": "Patients with end-stage renal disease were included.",
    "label": "not_supported"
  }
]