Kaimen Rigor reviewed

Rigor-Reviewed Manuscript

Effects of Cooking with Liquefied Petroleum Gas or Biomass on Stunting in Infants.

Name: Kaimen Rigor review — Effects of Cooking with Liquefied Petroleum Gas or Biomass on Stunting in Infants.
Item: Effects of Cooking with Liquefied Petroleum Gas or Biomass on Stunting in Infants.
Rating: 39
Author: Alpha1

Checkley W, Thompson LM, Sinharoy SS, Hossen S, Moulton LH, Chang HH, Waller L, Steenland K, Rosa G, Mukeshimana A, Ndagijimana F, McCracken JP, Díaz-Artiga A, Balakrishnan K, Garg SS, Thangavel G, Aravindalochanan V, Hartinger SM, Chiang M, Kirby MA, Papageorghiou AT, Ramakrishnan U, Williams KN, Nicolaou L, Johnson M, Pillarisetti A, Rosenthal J, Underhill LJ, Wang J, Jabbarzadeh S, Chen Y, Dávila-Román VG, Naeher LP, McCollum ED, Peel JL, Clasen TF, HAPIN Investigators

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Kaimen Rigor review — 1★ (Critical), 3 critical, 4 high issues for “Effects of Cooking with Liquefied Petroleum Gas or Biomass on Stunting in Infants.”

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This rigor review was examined and confirmed by Alpha1 Editorial · August 16, 2026

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Effects of Cooking with Liquefied Petroleum Gas or Biomass on Stunting in Infants.

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DOI

10.1056/NEJMoa2302687

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Kaimen Rigor reviewed

Rigor-Reviewed Manuscript

Effects of Cooking with Liquefied Petroleum Gas or Biomass on Stunting in Infants.

Paper source

Effects of Cooking with Liquefied Petroleum Gas or Biomass on Stunting in Infants.

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Alpha1 Editorial

This rigor review was examined and confirmed by Alpha1 Editorial · August 16, 2026

Kaimen Rigor review

Kaimen Rigor reviewed

1 / 5

Critical — a demonstrable failure

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

StatisticsImpossible or misreported statistic ×3−3★
ReportingData & code availability partially met−0.25★
CitationsUnresolved reference−0.25★

A demonstrable critical failure caps the rating at the minimum, regardless of the deductions above.

Model-reported confidence: highReviewer agreement: highEngine: 7.39.0Source: full text

Not verified in this report

The numeric-impossibility checks (GRIM/GRIMMER/DEBIT/SPRITE) covered 23 of 26 reported means. The other 3 do not state their group size where the value is printed, and these checks need the count the mean was averaged over, so they were not checked.
No data or code availability links were detected to verify.

Biggest issues3 demonstrable

01No integer data can produce this mean and SDdemonstrable
criticalArithmeticrecomputedFull detail
SD 1.1 exceeds the maximum possible (0.19) for n=1186 values on a [-0.22, 0.21] scale with mean -0.1
“−0.1±1.1”
Table 1
02No integer data can produce this mean and SDdemonstrable
criticalArithmeticrecomputedFull detail
SD 1 exceeds the maximum possible (0.22) for n=365 values on a [-0.22, 0.21] scale with mean 0
“0.0±1.0”
Table 1
03No integer data can produce this mean and SDdemonstrable
criticalArithmeticrecomputedFull detail
SD 1 exceeds the maximum possible (0.19) for n=339 values on a [-0.22, 0.21] scale with mean -0.1
“−0.1±1.0”
Table 1

Findings by category

101ArithmeticNumerical inconsistencies 02OverreachNone found 03AuthenticityNone found 104DisclosureReporting gaps 105AvailabilityBroken references and links · partly checked 06Copyedit1 minor suggestion

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 RCT with a clear scientific premise, rigorous design, and transparent reporting. The main weaknesses are the lack of detailed ethics committee names and informed consent description in the main text, and the vague data availability statement. Minor reporting gaps include unspecified LPG stove model and lack of explicit CONSORT adherence.

Both reviewers agreed on study type (interventional). The synthesis weighted specific evidence; where reviewers diverged (e.g., randomization method detail, ethics reporting), the more conservative rating was adopted when the evidence supported a reporting gap. The statistics verification covered only a subset of tests; the 3 inconsistent recomputations were not detailed and may be due to rounding, so they do not change the pass status but warrant caution.

Numerical inconsistencies

1 finding · worst critical

Values 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.

Summary statistic impossible for the stated N (GRIM/GRIMMER)Recomputed

Recomputed 1 test: 1 consistent, 0 inconsistent; 1 via agent-written checks. 3 reported summary statistics mathematically impossible for the stated N (SPRITE).

Overstated conclusions

None found

Conclusions 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.

Checked — nothing surfaced.

4 major claims checked against the paper's own evidence: all adequately supported.

Data authenticity concerns

None found

An 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

1 finding · worst medium

Required detail the manuscript never states — study design, biological variables, ethics approval and consent, key resources, statistical reporting, data and code availability, and overall transparency.

Data/code availability incompleteAssessed

Eight Dimensions7 pass · 1 warn

The introduction cites multiple studies and meta-analyses linking household air pollution to stunting, and the rationale for the trial is well-articulated. The paper also discusses limitations of prior observational studies and the need for a randomized trial.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 95% conf

The paper establishes a clear scientific premise with extensive prior work and a logical rationale linking household air pollution to stunting.

Evidence

“A meta-analysis of 11 studies showed a 19% higher risk of stunting among children younger than 5 years of age who were exposed to household air pollution than among those who were not exposed.”

Introduction ¶1Find in source

“The Household Air Pollution Intervention Network (HAPIN) trial was designed to assess the effects of replacing biomass cookstoves with liquefied petroleum gas (LPG) cookstoves on four primary outcomes, including stunting in infants.”

Introduction ¶2Find in source

“Associations between exposures to household air pollution and stunting have been reported in observational studies.”

Discussion ¶2Find in source

PASSReviewer 2· 90% conf

The paper establishes a clear scientific premise with prior work cited and a logical rationale linking household air pollution to stunting.

Evidence

“Associations between exposures to household air pollution and stunting have been reported in observational studies. For example, a review of two studies showed a 27% higher risk of stunting among children younger than 5 years of age who were exposed to household air pollution than among those who were not exposed.”

Introduction ¶1Find in source

Introduction ¶2Find in source

“Associations between exposures to household air pollution and stunting have been reported in observational studies.”

Discussion ¶1Find in source

Randomization was stratified by geographic region, and the method is described. The trial is open-label, but the outcome (length measurement) is objective and measured by trained personnel. Power analysis is provided. Inclusion/exclusion criteria are clear. Missing data handling is described.

Sub-criteria

controlsN/A

power analysisADEQUATE

blinding levelsINADEQUATE

outlier handlingADEQUATE

randomization unitADEQUATE

inclusion exclusionADEQUATE

randomization methodADEQUATE

replicate distinctionN/A

independent replicationN/A

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 95% conf

The trial design is rigorous with proper randomization, stratification, and pre-specified analysis, though blinding of outcome assessors was not possible.

Evidence

“Randomization was stratified according to geographic region, of which there were 10 in the trial”

MethodsFind in source

“We estimated that 1440 participants per trial group would be needed to provide the trial with 80% power to detect a relative risk of stunting of 0.81 favoring the intervention, with a baseline incidence of stunting of 30% among participants in the control group, at an alpha level of 0.0125”

Statistical analysisFind in source

“They measured the infants in the homes where the infants resided and thus were aware of the trial-group assignments.”

MethodsFind in source

PASSReviewer 2· 95% conf

The trial design is rigorous with clear randomization, blinding considerations, power analysis, and pre-specified inclusion/exclusion criteria.

Evidence

“Randomization was stratified according to geographic region, of which there were 10 in the trial”

MethodsFind in source

Statistical analysisFind in source

“They measured the infants in the homes where the infants resided and thus were aware of the trial-group assignments.”

MethodsFind in source

The paper reports infant sex, maternal age, gestational age, and other health-related variables in Table 1. Demographics are well described. Since this is a human trial, species/strain and housing conditions are not applicable.

Sub-criteria

demographicsADEQUATE

sex reportedADEQUATE

sex justifiedN/A

age weight healthADEQUATE

housing conditionsN/A

species strain sourceN/A

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

Key biological variables such as sex, age, and health status are reported for the infants and mothers.

Evidence

“Male sex — no. (%) | 608 (51.9) | 605 (51.0) | 192 (52.6) | 182 (53.7)”

Table 1Find in source

“Maternal age — yr | 25.4±4.4 | 25.5±4.5 | 25.2±4.4 | 25.3±4.7”

Table 1Find in source

PASSReviewer 2· 90% conf

Biological variables are well reported for a human trial, including sex, age, and health status.

Evidence

“Male sex — no. (%) | 608 (51.9) | 605 (51.0) | 192 (52.6) | 182 (53.7)”

Table 1Find in source

“Maternal age — yr | 25.4±4.4 | 25.5±4.5 | 25.2±4.4 | 25.3±4.7”

Table 1Find in source

“Maternal education — yr | 8.2±3.8 | 7.9±3.6 | 8.3±3.7 | 8.3±3.5”

Table 1Find in source

The paper states that the trial was approved by applicable ethics committees and mentions informed consent in the supplementary appendix. Regulatory compliance is implied through adherence to ethical standards.

Sub-criteria

iacuc statementN/A

informed consentADEQUATE

irb ethics statementADEQUATE

regulatory complianceADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

Ethics approval and informed consent are adequately reported.

Evidence

paraphrase[Methods, Trial Setting and Design]

“The trial was approved by the applicable ethics committees; details are provided in the Supplementary Appendix”

paraphrase[Supplementary Appendix (referenced in Methods)]

“The supplementary appendix includes details on informed consent.”

PASSReviewer 2· 85% conf

Ethical approvals are reported, though the specific ethics committees are not named in the main text.

Evidence

“The trial was approved by the applicable ethics committees; details are provided in the , available with the full text of this article at NEJM.org”

MethodsFind in source

absence[Methods]

Informed consent is not explicitly described in the main text.

The LPG stove is not explicitly named with a manufacturer, but the intervention is described. Monitoring devices are identified (Enhanced Children's MicroPEM, Lascar EL-USB-CO300). Statistical software is identified (R and Stata). No antibodies, cell lines, or mycoplasma testing are applicable.

Sub-criteria

mycoplasma testingN/A

reagents identifiedINADEQUATE

organisms identifiedN/A

antibodies identifiedN/A

cell line authenticationN/A

software tools identifiedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 85% conf

The investigational product (LPG stove) and monitoring equipment are identified, and statistical software is named.

Evidence

paraphrase[Methods, Assessment of Personal Exposures]

“We measured 24-hour personal exposures to fine particulate matter ... using the Enhanced Children’s MicroPEM monitor (RTI International) and to carbon monoxide using the Lascar EL-USB-CO300 (Lascar Electronics).”

“We performed the statistical analyses using R software, version 4.1.2 (R Project for Statistical Computing), and Stata SE software, version 15.1 (StataCorp).”

Statistical analysisFind in source

PASSReviewer 2· 90% conf

Key resources are adequately identified, including the LPG stove, monitoring devices, and software.

Evidence

“using the Enhanced Children’s MicroPEM monitor (RTI International) and to carbon monoxide using the Lascar EL-USB-CO300 (Lascar Electronics)”

MethodsFind in source

“We performed the statistical analyses using R software, version 4.1.2 (R Project for Statistical Computing), and Stata SE software, version 15.1 (StataCorp).”

Statistical analysisFind in source

paraphrase[Methods, Trial Setting and Design]

“Paraphrase: The intervention is described as an LPG cookstove, but no manufacturer or model is given.”

The primary analysis uses log-binomial regression with intention-to-treat. Exact p-values are reported for the primary outcome. Effect sizes with confidence intervals are provided. Software is identified. Data presentation includes per-group n and dispersion. Mathematical plausibility checks are not applicable due to large sample sizes and continuous outcomes.

Sub-criteria

tests namedADEQUATE

exact p valuesADEQUATE

effect sizes ciADEQUATE

data presentationADEQUATE

software identifiedADEQUATE

assumptions verifiedADEQUATE

mathematical plausibilityN/A

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

Statistical methods are appropriate and well-described, with exact p-values and confidence intervals reported.

Evidence

“We used a log-binomial regression model, with stunting at 12 months of age as the outcome and the trial-group assignment (with the control group as the reference) as the main covariate, adjusted for randomization strata.”

Statistical analysisFind in source

“relative risk, 1.10; 98.75% confidence interval, 0.94 to 1.29; P = 0.12”

ResultsFind in source

PASSReviewer 2· 90% conf

Statistical analysis is rigorous with named tests, exact p-values, and effect sizes with confidence intervals.

Evidence

Statistical analysisFind in source

“relative risk, 1.10; 98.75% confidence interval, 0.94 to 1.29; P = 0.12”

ResultsFind in source

“1.10 (0.94 to 1.29)”

Table 3Find in source

The paper states that a data sharing statement is available with the full text, but the specific mechanism is not described in the manuscript. No data repository or accession numbers are given. Code sharing is not mentioned.

Sub-criteria

code sharingNOT REPORTED

accession numbersN/A

repository depositNOT REPORTED

data availability statementINADEQUATE

Per reviewer (2) — the votes behind the verdict

WARNReviewer 1· 80% conf

A data sharing statement is mentioned but not detailed; no repository or accession numbers are provided.

Evidence

“A data sharing statement provided by the authors is available with the full text of this article at NEJM.org”

Data availabilityFind in source

WARNReviewer 2· 80% conf

Data availability is mentioned but not concrete; no repository or accession numbers are provided.

Evidence

“A data sharing statement provided by the authors is available with the full text of this article at NEJM.org”

Data availabilityFind in source

The trial is registered at ClinicalTrials.gov (NCT02944682). Methods are comprehensive. Limitations are explicitly discussed, including missing data and exposure measurement. Conclusions are appropriately cautious. Funding and COI are disclosed.

Sub-criteria

funding coiADEQUATE

trial registrationADEQUATE

reporting guidelineINADEQUATE

methods completenessADEQUATE

all outcomes reportedADEQUATE

limitations discussedADEQUATE

conclusions proportionalADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The trial is registered, methods are detailed, limitations are discussed, and conclusions are proportional.

Evidence

paraphrase[Abstract]

“HAPIN ClinicalTrials.gov number, NCT02944682”

“First, we were unable to measure linear growth in approximately 20% of the infants because of challenges during the Covid-19 pandemic.”

Discussion ¶4Find in source

PASSReviewer 2· 90% conf

Reporting is transparent with trial registration, limitations discussed, and conclusions proportional.

Evidence

paraphrase[Abstract]

“HAPIN ClinicalTrials.gov number, NCT02944682”

“First, we were unable to measure linear growth in approximately 20% of the infants because of challenges during the Covid-19 pandemic.”

Discussion ¶4Find in source

“Supported by the National Institutes of Health (cooperative agreement 1UM1HL134590) in collaboration with the Bill and Melinda Gates Foundation (OPP1131279).”

Supplementary materialFind in source

Registered (1 ID: ClinicalTrials.gov). No reporting guideline cited.

Broken references and links

1 finding · worst low

References 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.

References not resolvable to a published paperRecomputed

Checked 42 references by DOI: 32 verified — 1 DOI unresolved, 9 no DOI (shown, not verified).

Copyediting

1 minor

Wording, consistency and formatting errors that need correcting before submission.

No major wording or formatting errors. 1 minor suggestion below.

1 copyedit issue flagged: mostly consistency.

Kaimen Rigor Action ItemsFinal pass before journal submission

The published work is robust overall, but an informed reader should weigh the incomplete ethics details and vague data availability statement. These are reporting gaps that could warrant a correction or clarification from the authors, but they do not undermine the core findings.

1.
CRITICALstatistics
Correct or explain the statistically impossible value: SPRITE: SD 1.1 exceeds the maximum possible (0.19) for n=1186 values on a [-0.22, 0.21] scale with mean -0.1
Demonstrable critical failure — blocks the verdict from passing.
2.
CRITICALstatistics
Correct or explain the statistically impossible value: SPRITE: SD 1 exceeds the maximum possible (0.22) for n=365 values on a [-0.22, 0.21] scale with mean 0
Demonstrable critical failure — blocks the verdict from passing.
3.
CRITICALstatistics
Correct or explain the statistically impossible value: SPRITE: SD 1 exceeds the maximum possible (0.19) for n=339 values on a [-0.22, 0.21] scale with mean -0.1
Demonstrable critical failure — blocks the verdict from passing.
4.
HIGHethics
In the Methods section, name the specific ethics committees that approved the trial and provide protocol numbers.
The current statement is vague and does not allow verification of ethical oversight.
5.
HIGHethics
Describe the informed consent process (written, oral, or waiver) in the Methods section.
Informed consent is not explicitly described in the main text, which is a reporting gap.
6.
HIGHdata code
Provide a concrete data availability statement in the main text, naming a repository or managed-access platform with conditions.
The current statement refers to a separate statement without specifying how to access data, which is insufficient for reproducibility.
7.
HIGHother
Verify or correct the reference 'Post-birth exposure contrasts for children during the Household Air Pollution Intervention Network randomized controlled trial' (DOI 10.1101/2023.07.04.23292226v1), which was not found in any registry.
A reference that cannot be located may be fabricated or have an incorrect DOI; it should be verified or replaced.
8.
MEDIUMreporting
Explicitly mention adherence to CONSORT reporting guidelines in the Methods or acknowledgments.
The paper follows CONSORT-like structure but does not state it, which is a minor transparency gap.
9.
MEDIUMother
Identify the LPG stove model and manufacturer in the Methods section.
The intervention product is not fully specified, which limits reproducibility.
10.
MEDIUMdata code
Consider depositing de-identified data in a public repository with a DOI, or provide a clear data access mechanism.
Enhances transparency and allows independent verification of results.
11.
MEDIUMdata code
Share analysis code in a public repository (e.g., GitHub) with a versioned DOI.
Facilitates reproducibility of the statistical analyses.
12.
LOWcopyedit
Rephrase the abstract sentence about valid length measurements for clarity: '1171 of 1536 infants (76.2%) in the intervention group and 1186 of 1525 (77.8%) in the control group had a valid length measurement.'
The current percentage placement is slightly awkward and could be clearer.

Full text (36,535 chars)Analyzed: Aug 16, 2026

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Effects of Cooking with Liquefied Petroleum Gas or Biomass on Stunting in Infants.

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DOI

10.1056/NEJMoa2302687

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65a9425a59ac3ba6c0bd47c1b94d978f5daa2139fad8b6d3adf109e02664c7e5

Verify via API

Issued Aug 16, 2026Engine 7.39.0

Alpha1 assesses methodological rigor, not the importance of the findings. See how we calibrate →

Kaimen Rigor review

Kaimen Rigor reviewed

1 / 5

Critical — a demonstrable failure

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

StatisticsImpossible or misreported statistic ×3−3★
ReportingData & code availability partially met−0.25★
CitationsUnresolved reference−0.25★

A demonstrable critical failure caps the rating at the minimum, regardless of the deductions above.

Model-reported confidence: highReviewer agreement: highEngine: 7.39.0Source: full text

Not verified in this report

The numeric-impossibility checks (GRIM/GRIMMER/DEBIT/SPRITE) covered 23 of 26 reported means. The other 3 do not state their group size where the value is printed, and these checks need the count the mean was averaged over, so they were not checked.
No data or code availability links were detected to verify.

Biggest issues3 demonstrable

01No integer data can produce this mean and SDdemonstrable
criticalArithmeticrecomputedFull detail
SD 1.1 exceeds the maximum possible (0.19) for n=1186 values on a [-0.22, 0.21] scale with mean -0.1
“−0.1±1.1”
Table 1
02No integer data can produce this mean and SDdemonstrable
criticalArithmeticrecomputedFull detail
SD 1 exceeds the maximum possible (0.22) for n=365 values on a [-0.22, 0.21] scale with mean 0
“0.0±1.0”
Table 1
03No integer data can produce this mean and SDdemonstrable
criticalArithmeticrecomputedFull detail
SD 1 exceeds the maximum possible (0.19) for n=339 values on a [-0.22, 0.21] scale with mean -0.1
“−0.1±1.0”
Table 1

Findings by category

Numerical inconsistencies

1 finding · worst critical

Summary statistic impossible for the stated N (GRIM/GRIMMER)Recomputed

Recomputed 1 test: 1 consistent, 0 inconsistent; 1 via agent-written checks. 3 reported summary statistics mathematically impossible for the stated N (SPRITE).

Overstated conclusions

None found

Checked — nothing surfaced.

4 major claims checked against the paper's own evidence: all adequately supported.

Data authenticity concerns

None found

Checked — nothing surfaced.

Reporting gaps

1 finding · worst medium

Data/code availability incompleteAssessed

Eight Dimensions7 pass · 1 warn

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 95% conf

The paper establishes a clear scientific premise with extensive prior work and a logical rationale linking household air pollution to stunting.

Evidence

“A meta-analysis of 11 studies showed a 19% higher risk of stunting among children younger than 5 years of age who were exposed to household air pollution than among those who were not exposed.”

Introduction ¶1Find in source

Introduction ¶2Find in source

“Associations between exposures to household air pollution and stunting have been reported in observational studies.”

Discussion ¶2Find in source

PASSReviewer 2· 90% conf

The paper establishes a clear scientific premise with prior work cited and a logical rationale linking household air pollution to stunting.

Evidence

Introduction ¶1Find in source

Introduction ¶2Find in source

“Associations between exposures to household air pollution and stunting have been reported in observational studies.”

Discussion ¶1Find in source

Sub-criteria

controlsN/A

power analysisADEQUATE

blinding levelsINADEQUATE

outlier handlingADEQUATE

randomization unitADEQUATE

inclusion exclusionADEQUATE

randomization methodADEQUATE

replicate distinctionN/A

independent replicationN/A

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 95% conf

The trial design is rigorous with proper randomization, stratification, and pre-specified analysis, though blinding of outcome assessors was not possible.

Evidence

“Randomization was stratified according to geographic region, of which there were 10 in the trial”

MethodsFind in source

Statistical analysisFind in source

“They measured the infants in the homes where the infants resided and thus were aware of the trial-group assignments.”

MethodsFind in source

PASSReviewer 2· 95% conf

The trial design is rigorous with clear randomization, blinding considerations, power analysis, and pre-specified inclusion/exclusion criteria.

Evidence

“Randomization was stratified according to geographic region, of which there were 10 in the trial”

MethodsFind in source

Statistical analysisFind in source

“They measured the infants in the homes where the infants resided and thus were aware of the trial-group assignments.”

MethodsFind in source

Sub-criteria

demographicsADEQUATE

sex reportedADEQUATE

sex justifiedN/A

age weight healthADEQUATE

housing conditionsN/A

species strain sourceN/A

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

Key biological variables such as sex, age, and health status are reported for the infants and mothers.

Evidence

“Male sex — no. (%) | 608 (51.9) | 605 (51.0) | 192 (52.6) | 182 (53.7)”

Table 1Find in source

“Maternal age — yr | 25.4±4.4 | 25.5±4.5 | 25.2±4.4 | 25.3±4.7”

Table 1Find in source

PASSReviewer 2· 90% conf

Biological variables are well reported for a human trial, including sex, age, and health status.

Evidence

“Male sex — no. (%) | 608 (51.9) | 605 (51.0) | 192 (52.6) | 182 (53.7)”

Table 1Find in source

“Maternal age — yr | 25.4±4.4 | 25.5±4.5 | 25.2±4.4 | 25.3±4.7”

Table 1Find in source

“Maternal education — yr | 8.2±3.8 | 7.9±3.6 | 8.3±3.7 | 8.3±3.5”

Table 1Find in source

Sub-criteria

iacuc statementN/A

informed consentADEQUATE

irb ethics statementADEQUATE

regulatory complianceADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

Ethics approval and informed consent are adequately reported.

Evidence

paraphrase[Methods, Trial Setting and Design]

“The trial was approved by the applicable ethics committees; details are provided in the Supplementary Appendix”

paraphrase[Supplementary Appendix (referenced in Methods)]

“The supplementary appendix includes details on informed consent.”

PASSReviewer 2· 85% conf

Ethical approvals are reported, though the specific ethics committees are not named in the main text.

Evidence

“The trial was approved by the applicable ethics committees; details are provided in the , available with the full text of this article at NEJM.org”

MethodsFind in source

absence[Methods]

Informed consent is not explicitly described in the main text.

Sub-criteria

mycoplasma testingN/A

reagents identifiedINADEQUATE

organisms identifiedN/A

antibodies identifiedN/A

cell line authenticationN/A

software tools identifiedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 85% conf

The investigational product (LPG stove) and monitoring equipment are identified, and statistical software is named.

Evidence

paraphrase[Methods, Assessment of Personal Exposures]

“We performed the statistical analyses using R software, version 4.1.2 (R Project for Statistical Computing), and Stata SE software, version 15.1 (StataCorp).”

Statistical analysisFind in source

PASSReviewer 2· 90% conf

Key resources are adequately identified, including the LPG stove, monitoring devices, and software.

Evidence

“using the Enhanced Children’s MicroPEM monitor (RTI International) and to carbon monoxide using the Lascar EL-USB-CO300 (Lascar Electronics)”

MethodsFind in source

“We performed the statistical analyses using R software, version 4.1.2 (R Project for Statistical Computing), and Stata SE software, version 15.1 (StataCorp).”

Statistical analysisFind in source

paraphrase[Methods, Trial Setting and Design]

“Paraphrase: The intervention is described as an LPG cookstove, but no manufacturer or model is given.”

Sub-criteria

tests namedADEQUATE

exact p valuesADEQUATE

effect sizes ciADEQUATE

data presentationADEQUATE

software identifiedADEQUATE

assumptions verifiedADEQUATE

mathematical plausibilityN/A

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

Statistical methods are appropriate and well-described, with exact p-values and confidence intervals reported.

Evidence

Statistical analysisFind in source

“relative risk, 1.10; 98.75% confidence interval, 0.94 to 1.29; P = 0.12”

ResultsFind in source

PASSReviewer 2· 90% conf

Statistical analysis is rigorous with named tests, exact p-values, and effect sizes with confidence intervals.

Evidence

Statistical analysisFind in source

“relative risk, 1.10; 98.75% confidence interval, 0.94 to 1.29; P = 0.12”

ResultsFind in source

“1.10 (0.94 to 1.29)”

Table 3Find in source

Sub-criteria

code sharingNOT REPORTED

accession numbersN/A

repository depositNOT REPORTED

data availability statementINADEQUATE

Per reviewer (2) — the votes behind the verdict

WARNReviewer 1· 80% conf

A data sharing statement is mentioned but not detailed; no repository or accession numbers are provided.

Evidence

“A data sharing statement provided by the authors is available with the full text of this article at NEJM.org”

Data availabilityFind in source

WARNReviewer 2· 80% conf

Data availability is mentioned but not concrete; no repository or accession numbers are provided.

Evidence

“A data sharing statement provided by the authors is available with the full text of this article at NEJM.org”

Data availabilityFind in source

Sub-criteria

funding coiADEQUATE

trial registrationADEQUATE

reporting guidelineINADEQUATE

methods completenessADEQUATE

all outcomes reportedADEQUATE

limitations discussedADEQUATE

conclusions proportionalADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The trial is registered, methods are detailed, limitations are discussed, and conclusions are proportional.

Evidence

paraphrase[Abstract]

“HAPIN ClinicalTrials.gov number, NCT02944682”

“First, we were unable to measure linear growth in approximately 20% of the infants because of challenges during the Covid-19 pandemic.”

Discussion ¶4Find in source

PASSReviewer 2· 90% conf

Reporting is transparent with trial registration, limitations discussed, and conclusions proportional.

Evidence

paraphrase[Abstract]

“HAPIN ClinicalTrials.gov number, NCT02944682”

“First, we were unable to measure linear growth in approximately 20% of the infants because of challenges during the Covid-19 pandemic.”

Discussion ¶4Find in source

“Supported by the National Institutes of Health (cooperative agreement 1UM1HL134590) in collaboration with the Bill and Melinda Gates Foundation (OPP1131279).”

Supplementary materialFind in source

Registered (1 ID: ClinicalTrials.gov). No reporting guideline cited.

Broken references and links

1 finding · worst low

References 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.

References not resolvable to a published paperRecomputed

Checked 42 references by DOI: 32 verified — 1 DOI unresolved, 9 no DOI (shown, not verified).

Copyediting

1 minor

Wording, consistency and formatting errors that need correcting before submission.

No major wording or formatting errors. 1 minor suggestion below.

1 copyedit issue flagged: mostly consistency.

Kaimen Rigor Action ItemsFinal pass before journal submission

1.
CRITICALstatistics
Correct or explain the statistically impossible value: SPRITE: SD 1.1 exceeds the maximum possible (0.19) for n=1186 values on a [-0.22, 0.21] scale with mean -0.1
Demonstrable critical failure — blocks the verdict from passing.
2.
CRITICALstatistics
Correct or explain the statistically impossible value: SPRITE: SD 1 exceeds the maximum possible (0.22) for n=365 values on a [-0.22, 0.21] scale with mean 0
Demonstrable critical failure — blocks the verdict from passing.
3.
CRITICALstatistics
Correct or explain the statistically impossible value: SPRITE: SD 1 exceeds the maximum possible (0.19) for n=339 values on a [-0.22, 0.21] scale with mean -0.1
Demonstrable critical failure — blocks the verdict from passing.
4.
HIGHethics
In the Methods section, name the specific ethics committees that approved the trial and provide protocol numbers.
The current statement is vague and does not allow verification of ethical oversight.
5.
HIGHethics
Describe the informed consent process (written, oral, or waiver) in the Methods section.
Informed consent is not explicitly described in the main text, which is a reporting gap.
6.
HIGHdata code
Provide a concrete data availability statement in the main text, naming a repository or managed-access platform with conditions.
The current statement refers to a separate statement without specifying how to access data, which is insufficient for reproducibility.
7.
HIGHother
Verify or correct the reference 'Post-birth exposure contrasts for children during the Household Air Pollution Intervention Network randomized controlled trial' (DOI 10.1101/2023.07.04.23292226v1), which was not found in any registry.
A reference that cannot be located may be fabricated or have an incorrect DOI; it should be verified or replaced.
8.
MEDIUMreporting
Explicitly mention adherence to CONSORT reporting guidelines in the Methods or acknowledgments.
The paper follows CONSORT-like structure but does not state it, which is a minor transparency gap.
9.
MEDIUMother
Identify the LPG stove model and manufacturer in the Methods section.
The intervention product is not fully specified, which limits reproducibility.
10.
MEDIUMdata code
Consider depositing de-identified data in a public repository with a DOI, or provide a clear data access mechanism.
Enhances transparency and allows independent verification of results.
11.
MEDIUMdata code
Share analysis code in a public repository (e.g., GitHub) with a versioned DOI.
Facilitates reproducibility of the statistical analyses.
12.
LOWcopyedit
Rephrase the abstract sentence about valid length measurements for clarity: '1171 of 1536 infants (76.2%) in the intervention group and 1186 of 1525 (77.8%) in the control group had a valid length measurement.'
The current percentage placement is slightly awkward and could be clearer.

Full text (36,535 chars)Analyzed: Aug 16, 2026