Standard chemoradiotherapy with concurrent and adjuvant camrelizumab in patients with high risk nasopharyngeal carcinoma: multicentre, randomised, open label, phase 3 trial.
You R, Xu GQ, Ding X, Liang JH, Liu ZG, Zou X, Liu YP, Hu GY, Liu YM, Duan CY, Liu LZ, Zhang WJ, Liu Q, Li HF, Ouyang YF, Duan XT, Wang Q, Peng L, Liang JL, Feng ZK, Qin ZH, Liu X, He ZK, Zhang B, Long GX, Jiang YH, Lei F, Huang PY, Hua YJ, Chen MY
- DOI
- 10.1136/bmj-2025-085863
- Record issued
- 2026-08-15
- Engine
- 7.39.0
- Exported
- 2026-09-20
Prepared by Alpha1. This document is confidential: it is intended for the recipient it was shared with and must not be redistributed. The live record at alpha1science.com/verify/0f603dd9-7523-4981-9fda-3d51a0186db4 is authoritative.
How this rating was calculated
- IntegrityIntegrity concern ×2−1★
This Kaimen Rigor review uses Kaimen Rigor reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.
This is a well-conducted and transparently reported phase 3 randomised trial. The methods are rigorous, with clear randomization, blinding of central reviewers, pre-specified sample size, and appropriate statistical analysis. Reporting is thorough, including trial registration, CONSORT adherence, data availability, and ethics approvals.
Both reviewers independently scored all eight dimensions as 'pass' with high confidence, and their evidence was consistent. The study type is interventional (phase 3 trial). Non-applicable sub-criteria (e.g., animal housing, cell line authentication) were excluded. The statistics verification recomputed 5 reported tests consistently, but this does not confirm the entire analysis; threshold-only p-values and resampling-based tests were not machine-verified.
Numerical inconsistencies
1 finding · worst lowValues that contradict each other or are impossible for the stated sample: recomputed p-values and test statistics, GRIM/GRIMMER checks on summary numbers, percentages against their own counts, totals against their parts, and estimates against their own confidence intervals.
- Internal contradictions in the reported numbersAssessed
Recomputed 5 tests: 5 consistent, 0 inconsistent; 1 recomputed directly from the reported test statistics, 4 via agent-written checks.
- CONSISTENTreported p = .001 · recomputed p = .001Recomputed hazard ratio 0.51 (95% CI 0.34–0.77), reported p=0.001
“hazard ratio 0.51, 95% confidence interval 0.34 to 0.77, P=0.001”
Taken as given: 0.34–0.77 is a two-sided 95% confidence interval for the hazard ratio of 0.51, not a range, an IQR, or a different interval level; the hazard ratio is a RATIO measure, so the interval is symmetric on the log scale; p=0.001 is the p for THIS estimate, not for another comparison in the same sentenceMethod: back the two-tailed p out of the log-scale CI width and compare it against the printed pHow we recomputed it: pCI(0.51, 0.34, 0.77, 1) - CONSISTENTreported p = .001 · recomputed p = .001Reviewers 1, 2Primary endpoint progression-free survival hazard ratio p-value
“stratified hazard ratio 0.51, 95% confidence interval 0.34 to 0.77, P=0.001”
Taken as given: The hazard ratio is 0.51 with 95% CI 0.34 to 0.77.; The CI is two-sided at 95%.; The p-value is two-tailed.Method: Recomputed p-value from hazard ratio and 95% CI using the normal approximation for the log hazard ratio.How we recomputed it: pCI(0.51, 0.34, 0.77, 1) - CONSISTENTreported p = .190 · recomputed p = .184Reviewers 1, 2Overall survival hazard ratio p-value
“stratified hazard ratio for death 0.59, 95% CI 0.27 to 1.28”
Taken as given: The hazard ratio is 0.59 with 95% CI 0.27 to 1.28.; The CI is two-sided at 95%.; The p-value is two-tailed.Method: Recomputed p-value from hazard ratio and 95% CI using the normal approximation for the log hazard ratio.How we recomputed it: pCI(0.59, 0.27, 1.28, 1) - CONSISTENTreported p = .020 · recomputed p = .019Reviewers 1, 2Distant metastasis-free survival hazard ratio p-value
“stratified hazard ratio for distant metastasis or death 0.54, 95% CI 0.32 to 0.90”
Taken as given: The hazard ratio is 0.54 with 95% CI 0.32 to 0.90.; The CI is two-sided at 95%.; The p-value is two-tailed.Method: Recomputed p-value from hazard ratio and 95% CI using the normal approximation for the log hazard ratio.How we recomputed it: pCI(0.54, 0.32, 0.90, 1) - CONSISTENTreported p = .001 · recomputed p = .002Reviewers 1, 2Locoregional recurrence-free survival hazard ratio p-value
“stratified hazard ratio for locoregional relapse or death 0.38, 95% CI 0.21 to 0.70”
Taken as given: The hazard ratio is 0.38 with 95% CI 0.21 to 0.70.; The CI is two-sided at 95%.; The p-value is two-tailed.Method: Recomputed p-value from hazard ratio and 95% CI using the normal approximation for the log hazard ratio.How we recomputed it: pCI(0.38, 0.21, 0.70, 1)
- lowinternal contradictionThe abstract reports 390 patients enrolled, but the results section states 698 were screened and 390 enrolled; this is consistent. However, the safety population is 186 and 189, which is less than the randomized numbers, but this is explained by protocol deviations.
“Overall, 186 patients (95.9%) in the camrelizumab group and 189 (96.4%) in the standard treatment group started protocol defined treatment (safety population; ).”
ResultsFind in source - lowinternal contradictionThe text states '318 of 363 patients were alive (87.6%)' but the total number of patients with follow-up records of at least 36 months is not clearly defined; this could be a subset, but the denominator 363 is not explained.
“As of this date, 318 of 363 patients were alive (87.6%) with follow-up records of at least 36 months, while the last enrolled patient had a final follow-up time of 29.4 months.”
ResultsFind in source
Overstated conclusions
1 finding · worst lowConclusions that reach past what the paper's own results support — including a significance claim that no longer holds when the statistic is recomputed, and efficacy resting on an unvalidated surrogate endpoint.
- Conclusions only partially backed by the presented evidenceAssessed
4 major claims checked against the paper's own evidence: 1 only partially supported (evidence backs part of the claim; gaps or caveats remain); the rest adequately supported.
- partialReviewers 1, 2The study validates the precision treatment concept of using dynamic imaging assessment and Epstein-Barr virus DNA changes to individualise subsequent treatment intensity in nasopharyngeal carcinoma.The study demonstrates the feasibility of using response to induction chemotherapy to select high-risk patients, but it does not directly compare with a non-precision approach, so the validation is indirect.Evidence: The study design uses response to induction chemotherapy to define high-risk patients, and the results show benefit in this group.
This study validates the precision treatment concept of using dynamic imaging assessment and Epstein-Barr virus DNA changes to individualise subsequent treatment intensity in nasopharyngeal carcinoma.
Discussionreviewer’s wording - supportedReviewers 1, 2The addition of camrelizumab to concurrent chemoradiotherapy and as maintenance treatment improved progression-free survival among patients with high risk nasopharyngeal carcinoma after induction chemotherapy.The primary endpoint progression-free survival was significantly improved with a hazard ratio of 0.51 (95% CI 0.34-0.77, P=0.001), directly supporting the claim.Evidence: Table 2 and Abstract report the primary endpoint result.
“The addition of camrelizumab to concurrent chemoradiotherapy and as a maintenance treatment improved progression-free survival among patients with high risk nasopharyngeal carcinoma after induction chemotherapy.”
ConclusionFind in source - supportedReviewers 1, 2The addition of camrelizumab decreased the risk of locoregional recurrence and distant metastasis.Secondary endpoints distant metastasis-free survival and locoregional relapse-free survival were both significantly improved, supporting the claim.Evidence: Table 2 reports hazard ratios for distant metastasis-free survival (0.54, 95% CI 0.32-0.90) and locoregional relapse-free survival (0.38, 95% CI 0.21-0.70).
“The progression-free survival benefit of camrelizumab was accompanied by a significantly decreased risk of locoregional recurrence and distant metastasis, although there were no statistically significant differences in overall survival at the data cut-off time point.”
DiscussionFind in source - supportedReviewers 1, 2Camrelizumab with concurrent chemoradiotherapy and as maintenance treatment showed a favourable safety profile.The safety profile is described with grade 3 or higher adverse events in 11% of patients, comparable to other studies, supporting the claim.Evidence: Results, Adverse events section reports grade 3-4 adverse events and immune-related adverse events.
“Camrelizumab concurrent with chemoradiotherapy and as a maintenance treatment showed a favourable safety profile, with grade 3 or higher adverse events reported in 11% of patients.”
DiscussionFind in source
Efficacy claim is anchored to an adequate endpoint and a meaningful effect.
- ADEQUATESurrogate endpointThe primary endpoint is progression-free survival, a hard clinical outcome (time to recurrence or death), not a surrogate. The efficacy claim is based on this clinical endpoint.
“The primary endpoint in the intention-to-treat group was progression-free survival, defined as the time from randomisation to disease recurrence (locoregional or distant) or death from any cause.”
- ADEQUATEEffect sizeThe effect size is a 12.1% absolute improvement in 36-month progression-free survival (83.4% vs 71.3%) with a hazard ratio of 0.51 (95% CI 0.34 to 0.77), which is statistically significant and clinically meaningful in the context of nasopharyngeal carcinoma.
“progression-free survival was higher in the camrelizumab group than the standard treatment group (36 months: 83.4%, 95% confidence interval 78.3% to 88.8% v 71.3%, 65.2% to 77.9%; stratified hazard ratio 0.51, 95% confidence interval 0.34 to 0.77, P=0.001).”
Data authenticity concerns
None foundAn adversarial read for patterns associated with data that may not be genuine: results that look too clean, implausibly large effects, duplicated data or images, and methods that do not match the results reported.
Checked — nothing surfaced.
Reporting gaps
None foundRequired detail the manuscript never states — study design, biological variables, ethics approval and consent, key resources, statistical reporting, data and code availability, and overall transparency.
Checked — nothing surfaced.
The introduction cites prior work on induction chemotherapy, risk stratification tools, and phase 3 trials of PD-1 inhibitors, acknowledging both strengths and limitations. The rationale for using camrelizumab in high-risk patients is clearly derived from the cited evidence, and the study addresses limitations of prior research by using dynamic response assessment and central review.
“Several phase 3 trials have shown that adding programmed death 1 (PD-1) inhibitors to chemotherapy as first line treatment for recurrent or metastatic nasopharyngeal carcinoma provided statistically significantly and clinically meaningful benefits in terms of progression-free and overall survival compared with chemotherapy alone.”
“Therefore, the addition of PD-1 inhibitors to the chemoradiotherapy regimen after induction chemotherapy may be a promising treatment strategy for this high risk population.”
“We used central imaging evaluation and central serial EBV DNA testing after induction chemotherapy to accurately screen patients for eligibility for the addition of PD-1 inhibitors, rather than relying solely on baseline radiological staging.”
“In search of new treatments, several phase 3 trials have shown that adding programmed death 1 (PD-1) inhibitors to chemotherapy as first line treatment for recurrent or metastatic nasopharyngeal carcinoma provided statistically significantly and clinically meaningful benefits in terms of progression-free and overall survival compared with chemotherapy alone.”
“Retrospective studies have indicated that the tumour response after induction chemotherapy based on radiological examination was an independent prognostic indicator of survival outcomes for patients with stage 2-4a nasopharyngeal carcinoma.”
“However, considerable heterogeneity remains for most cancer subtypes—patients with similar pretreatment staging may have different survival outcomes despite receiving the same treatment.”
Randomization was centralized and stratified by centre and stage, with the block structure concealed. The trial was open-label but central imaging reviewers were masked. A power analysis was performed with a target hazard ratio and 388 participants estimated. Inclusion/exclusion criteria were pre-specified. The analysis population (ITT) and safety population were defined, and missing data were handled via censoring. The comparator arm serves as the control.
“The centralised randomisation procedure was conducted in the current study. Only the study coordinator and statistician knew the block structure, and they had no involvement in clinical aspects of the trial.”
“The treatment group assignment was known to the investigators and patients (open label), but this was masked to the central imaging review committee members (W-JZ, L-ZL), who reviewed the imaging results of patients without access to information about treatment.”
“Based on a presumed 10% dropout rate, a total of 388 participants were estimated to be required (194 participants in each group), allowing for 98 events in the primary analysis of progression-free survival.”
“Patients were enrolled after completing three cycles of induction chemotherapy, stratified by treatment centre and disease stage (2-3 v 4a), and were randomly assigned (1:1) to receive cisplatin based concurrent chemoradiotherapy (standard treatment group) or concurrent chemoradiotherapy plus concurrent and adjuvant camrelizumab (camrelizumab group).”
“The treatment group assignment was known to the investigators and patients (open label), but this was masked to the central imaging review committee members (W-JZ, L-ZL), who reviewed the imaging results of patients without access to information about treatment.”
“Based on a presumed 10% dropout rate, a total of 388 participants were estimated to be required (194 participants in each group), allowing for 98 events in the primary analysis of progression-free survival.”
Sex is reported in Table 1 (107 women, 283 men). Age is reported as median with IQR. Demographics include Karnofsky performance status, BMI, smoking, drinking, and family history. Species/strain and housing conditions are not applicable as this is a human trial.
“Female | 57 (29.4) | 50 (25.5) | | Male | 137 (70.6) | 146 (74.5)”
“The median age was 46.0 (interquartile range 36.8-54.0) in the camrelizumab group and 45.0 (35.0-54.0) in the standard treatment group.”
“Karnofsky performance status score | | 90-100 | 192 (99.0) | 193 (98.5) | | 70-80 | 2 (1.0) | 3 (1.5)”
“The population consisted of 107 women (27.4%) and 283 men (72.6%).”
“Age (years), median (IQR) | 46.0 (36.8-54.0) | 45.0 (35.0-54.0)”
The study was approved by the institutional review board of Sun Yat-sen University Cancer Center (B2020-131-01) and respective ethics committees. Written informed consent was obtained from eligible patients. The trial conformed to the Declaration of Helsinki.
“The study was approved by the institutional review board of the Sun Yat-sen University Cancer Center (B2020-131-01) and respective ethics committee of each participating centre.”
“Eligibility assessment and obtaining written informed consent from eligible patients was the responsibility of investigators at each centre.”
“The trial conformed to the Declaration of Helsinki and the reporting of results was based on the CONSORT (consolidated standards of reporting trials) statement.”
“The study was approved by the institutional review board of the Sun Yat-sen University Cancer Center (B2020-131-01) and respective ethics committee of each participating centre.”
“Eligibility assessment and obtaining written informed consent from eligible patients was the responsibility of investigators at each centre.”
“The trial conformed to the Declaration of Helsinki and the reporting of results was based on the CONSORT (consolidated standards of reporting trials) statement.”
Camrelizumab is identified as a PD-1 inhibitor with dose (200 mg) and regimen (19 cycles). Cisplatin and gemcitabine are also identified with doses. Statistical software (SPSS 25.0 and R 4.4.1) is identified. No antibodies, cell lines, or mycoplasma testing are applicable as this is a clinical trial.
“Patients in the camrelizumab group received 200 mg camrelizumab intravenously over a minimum duration of 60 minutes on the initial day of radiotherapy, once every three weeks for two cycles during intensity modulated radiotherapy.”
“Analyses were performed using SPSS software (version 25.0; IBM, Armonk, NY, USA) and R version 4.4.1.”
“Patients in the camrelizumab group received 200 mg camrelizumab intravenously over a minimum duration of 60 minutes on the initial day of radiotherapy, once every three weeks for two cycles during intensity modulated radiotherapy.”
“All patients were administered three cycles of induction chemotherapy comprising intravenous cisplatin (80 mg/m 2 on day 1) and gemcitabine (1 g/m 2 on days 1 and 8 of each 21 day cycle) once every three weeks.”
“Analyses were performed using SPSS software (version 25.0; IBM, Armonk, NY, USA) and R version 4.4.1.”
The primary analysis used stratified log-rank test and Cox proportional hazards model with Schoenfeld residuals for proportional hazards assumption. Effect sizes are reported as hazard ratios with 95% CIs. Exact p-values are reported for primary and secondary endpoints. Software is identified. Data presentation includes Kaplan-Meier curves and per-group n. Mathematical plausibility checks were not applicable due to large N and continuous outcomes.
“Time-to-event data were visualised using Kaplan-Meier curves, and compared using the stratified log rank test. The hazard ratio and 95% confidence intervals (CIs) were calculated using a Cox proportional hazards model, with covariates including the overall stage (2-3 v 4), treatment group, and trial centre, while the proportional hazards assumption was tested using Schoenfeld residuals.”
“0.51 (0.34 to 0.77) | 0.001”
“stratified hazard ratio 0.51, 95% confidence interval 0.34 to 0.77, P=0.001”
“Time-to-event data were visualised using Kaplan-Meier curves, and compared using the stratified log rank test.”
“The hazard ratio and 95% confidence intervals (CIs) were calculated using a Cox proportional hazards model, with covariates including the overall stage (2-3 v 4), treatment group, and trial centre, while the proportional hazards assumption was tested using Schoenfeld residuals.”
“stratified hazard ratio for recurrence or death 0.51, 95% CI 0.34 to 0.77, P=0.001”
The data availability statement states that data are openly available in Dryad with a DOI, and code is in supplemental files. This is a concrete access route, satisfying the criterion.
“The data underlying the findings in this paper are openly and publicly available in Dryad and can be found here: https://doi.org/10.5061/dryad.3j9kd51zg .”
“The code used to analyse the data in the paper can be found in the supplemental files.”
“The data underlying the findings in this paper are openly and publicly available in Dryad and can be found here: https://doi.org/10.5061/dryad.3j9kd51zg .”
“The code used to analyse the data in the paper can be found in the supplemental files.”
The trial is registered at ClinicalTrials.gov (NCT04453826). The paper states reporting is based on CONSORT. Limitations are discussed in the Discussion. Funding sources and competing interests are declared. Conclusions are proportional to the evidence, noting the need for longer follow-up for overall survival.
“Trial registration ClinicalTrials.gov NCT04453826 (https://clinicaltrials.gov/ct2/show/NCT04453826)”
“The trial conformed to the Declaration of Helsinki and the reporting of results was based on the CONSORT (consolidated standards of reporting trials) statement.”
“Additionally, this was an open label trial, which may have introduced biases that could be excluded in a double blind placebo controlled design.”
“Trial registration ClinicalTrials.gov NCT04453826 (https://clinicaltrials.gov/ct2/show/NCT04453826)”
“The trial conformed to the Declaration of Helsinki and the reporting of results was based on the CONSORT (consolidated standards of reporting trials) statement.”
“Additionally, this was an open label trial, which may have introduced biases that could be excluded in a double blind placebo controlled design.”
Registered (2 IDs: ClinicalTrials.gov). Reporting guideline cited: CONSORT.
Broken references and links
None foundReferences checked against Crossref, OpenAlex and Retraction Watch for retractions and resolvability, plus declared data and code links probed for whether they resolve to content matching the paper.
Checked — nothing surfaced.
Checked 39 references by DOI: 38 verified — 1 no DOI (shown, not verified).
- NO DOIHead and Neck Cancers (Version 1.2020)No DOI in the reference — shown for manual review; not independently verifiable (not a fabrication signal).
1 data/code link checked; 1 live.
- dataDryadLIVEHTTP 200https://doi.org/10.5061/dryad.3j9kd51zgResolves to Dryad (data repository).
Copyediting
7 minorWording, consistency and formatting errors that need correcting before submission.
No major wording or formatting errors. 7 minor suggestions below.
7 copyedit issues flagged: mostly typo, consistency, clarity.
- MINORtypoDiscussion, Comparison with other studies“CONTINNUMM”→ CONTINUUMTypo in the name of the CONTINUUM study.
- MINORconsistencyTable 3“124(66.7)”→ 124 (66.7)Missing space before parenthesis.
- MINORclarityDiscussion, Comparison with other studies“radiologicaland biological response”→ radiological and biological responseMissing space between 'radiological' and 'and'.
- MINORtypoAbstract, Results“immunological adverse events”→ Consider using 'immune-related adverse events' for consistency with the rest of the text.The abstract uses 'immunological' while the text uses 'immune-related'.
- MINORconsistencyDiscussion, Comparison with other studies“CONTINNUMM”→ Change to 'CONTINUUM' for consistency.Typo in the name of the CONTINUUM study.
- MINORpunctuationTable 3, Vomiting row“124(66.7)”→ Add a space before the parenthesis for consistency with other entries.Missing space in the cell.
- MINORclarityDiscussion, Comparison with other studies“the added low dose maintenance chemotherapy can be regarded as a valid control”→ Clarify which study this refers to and the context.The sentence is somewhat ambiguous.
The published work is robust and well-reported. An informed reader should weigh the open-label design and the fact that only a subset of statistical tests were independently recomputed; however, no major rigor gaps were identified. Minor copyedit issues (typos, spacing) do not affect the scientific integrity.
- 1.MEDIUMcopyeditFix the typo 'CONTINNUMM' to 'CONTINUUM' in the Discussion, Comparison with other studies.The study name is misspelled, which could confuse readers and appears unprofessional.
- 2.MEDIUMcopyeditAdd a space before the parenthesis in Table 3, Vomiting row: change '124(66.7)' to '124 (66.7)'.Consistency in formatting improves readability and professionalism.
- 3.MEDIUMcopyeditFix the missing space in 'radiologicaland biological response' in the Discussion, Comparison with other studies.Typographical error affects clarity.
- 4.MEDIUMcopyeditStandardize terminology: change 'immunological adverse events' in the Abstract to 'immune-related adverse events' for consistency with the rest of the text.Consistent terminology is important for clarity and avoids confusion.
- 5.MEDIUMreportingClarify the sentence in the Discussion, Comparison with other studies: 'the added low dose maintenance chemotherapy can be regarded as a valid control' — specify which study this refers to and the context.The sentence is ambiguous and could be misinterpreted.
- 6.MEDIUMreportingAdd a CONSORT flow diagram to the main text to show patient disposition (screened, excluded, randomized, analyzed).Enhances transparency and is a key CONSORT requirement.
- 7.MEDIUMreportingReport the exact p-values for all secondary endpoints in the text or tables, rather than only thresholds like P<0.05.Exact p-values allow readers to assess the strength of evidence more precisely.
- 8.MEDIUMreportingReport the results of the Schoenfeld residuals test for the proportional hazards assumption in the Results section.The Methods state the test was performed, but the results are not reported, which is a reporting gap.
- 9.MEDIUMreportingProvide the number of patients screened but not enrolled, and reasons for exclusion, to enhance generalizability.This information is important for assessing external validity.
- 10.LOWdata codeConsider providing the statistical analysis code in a version-controlled public repository (e.g., GitHub) with a permanent identifier, rather than only in supplemental files.Version-controlled code with a DOI is more reproducible and citable.
- 11.LOWdata codeSpecify any conditions or timeframe for access to the Dryad repository data in the data availability statement.Clarifies access terms for readers.
- 12.LOWreportingAdd a statement about the availability of the full statistical analysis plan or protocol in the data availability statement.Increases transparency and reproducibility.
- 13.LOWreportingProvide the full list of participating centres and their ethics committees in the supplementary materials.Enhances transparency about the study's governance.
- 14.LOWreportingReport the exact number of patients who discontinued camrelizumab due to each reason in the main text, rather than only in supplementary tables.Important for assessing tolerability and adherence.
- 15.LOWreportingDiscuss the potential impact of the open-label design on the assessment of subjective outcomes, such as quality of life, in more depth.Acknowledging this limitation strengthens the discussion.
The star rating is the report’s one-glance summary. Every paper starts at 5★ and loses stars for the concrete problems the review finds — so a rating is never a vague average, it’s a running total you can read line by line under “How this rating was calculated.”
- Reporting — 8 dimensionseach dimension that fully fails−½★
- each dimension partially met−¼★
- Statistics · Integrity · Claimseach serious problem−1★
- each medium problem−½★
- Citationseach retracted or unverifiable reference−¼★
- Copyeditonly when the manuscript needs a full edit−½★
The rating never drops below 1★, and a demonstrable critical failure (an impossible statistic, a proven ethics violation) caps it at 1★ on its own — so the stars can never look healthy when the verdict is CRITICAL.
The rating draws on a panel of agents. Three independent Kaimen Rigor reviewers grade the eight dimensions below across several independent passes (the shown verdict is their majority vote — steadier than any single run), isolate the paper’s major claims and check its own evidence backs them, and flag integrity concerns. Alongside them, a citation agent resolves every reference against Crossref, OpenAlex, and Retraction Watch; a statistics agent recomputes reported tests; and rule-based checks verify that declared data/code links actually resolve. Full text is required — an abstract-only submission is not analyzed.
Graded against NIH, MDAR, ARRIVE 2.0, CONSORT, EQUATOR, and RRID guidelines. A dimension that doesn’t apply to the study type is skipped, never penalized.
This Kaimen Rigor review is model-assisted and is not a substitute for formal expert review. It complements human evaluation by surfacing potential methodological concerns — verify each finding against the source.