Rigor Reviewed

Rigor-Reviewed Manuscript

Care guided by tissue oxygenation and haemodynamic monitoring in off-pump coronary artery bypass grafting (Bottomline-CS): assessor blind, single centre, randomised controlled trial.

Name: Αlpha¹ Rigor Record — Care guided by tissue oxygenation and haemodynamic monitoring in off-pump coronary artery bypass grafting (Bottomline-CS): assessor blind, single centre, randomised controlled trial.
Item: Care guided by tissue oxygenation and haemodynamic monitoring in off-pump coronary artery bypass grafting (Bottomline-CS): assessor blind, single centre, randomised controlled trial.
Rating: 100
Author: Αlpha¹

Han J, Zhai W, Wu Z, Zhang Z, Wang T, Ren M, Liu Z, Sessler DI, Guo Z, Meng L, Bottomline-CS investigation group

Paper source

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Αlpha¹ Rigor Review — 2.75★ (Weak), 0 critical, 1 high issue for “Care guided by tissue oxygenation and haemodynamic monitoring in off-pump coronary artery bypass grafting (Bottomline-CS): assessor blind, single centre, randomised controlled trial.”

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Αlpha¹ Editorial

This rigor review was examined and confirmed by Αlpha¹ Editorial · August 15, 2026

Αlpha¹ Rigor Review

Rigor Reviewed

2.75 / 5

Weak — serious problems found

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern ×2−1★
ClaimsEfficacy rests on an unvalidated surrogate endpoint−0.5★
ClaimsTreatment effect not shown to be clinically meaningful−0.5★
CitationsUnresolved reference−0.25★

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

Not verified in this report

The numeric-impossibility checks (GRIM/GRIMMER/DEBIT/SPRITE) did not run: 34 reported means were read, and their group size is not stated where the values are printed (this source has no machine-readable table structure). These checks need the count the mean was averaged over, so none was performed.

Problems surfaced6 types

Numerical inconsistencies1

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.

Internal contradictions in the reported numbersAssessed

Overstated conclusions3

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.

Efficacy rests on an unvalidated surrogate endpointAssessed
Treatment effect not shown to be clinically meaningfulAssessed
Conclusions only partially backed by the presented evidenceAssessed

Data authenticity concerns1

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.

Other integrity concernAssessed

Broken references and links1

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

This Αlpha¹ Rigor Review uses AI 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 randomised controlled trial. The design is rigorous (randomisation, blinding of assessors, pre-specified sample size), ethical approvals and data/code availability are clearly documented, and the statistical analysis is appropriately described with exact p-values and effect sizes. Minor copyedit issues and a single unresolved reference are the only notable weaknesses.

Both reviewers classified the study as interventional (RCT), and I adopt that classification. The evaluation covered all eight rigor dimensions; non-applicable sub-criteria (e.g., species/strain, housing, IACUC, cell lines) were excluded. The statistics component verified only a subset of tests (those with test statistics/df or effect estimates with CIs); threshold-only p-values and resampling-based p-values were not machine-verified. The citation check flagged one reference not found in any registry.

7 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.

Premise concern: surrogate not validated for clinical benefit; effect size not shown to be clinically meaningful.

Recomputed 5 tests: 5 consistent, 0 inconsistent; 2 recomputed directly from the reported test statistics, 3 via agent-written checks.

2 integrity concerns flagged (0 high).

Reporting

Eight Dimensions8 pass

The introduction cites prior cohort studies linking tissue desaturation to worse outcomes and notes that previous randomised trials were small, underpowered, and focused solely on cerebral oximetry. It explicitly states the limitations of prior work (e.g., 'These trials were often small (the largest enrolling 249 patients), inadequately powered, and focused solely on cerebral tissue oxygen saturation') and explains how the current study addresses these gaps by using multisite monitoring and continuous haemodynamic data. The hypothesis follows logically from the cited evidence.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The paper establishes a clear scientific premise by citing prior research, identifying gaps, and providing a logical rationale for the study hypothesis.

Evidence

direct quote[Introduction, paragraph 3]

“These trials were often small (the largest enrolling 249 patients), inadequately powered, and focused solely on cerebral tissue oxygen saturation—potentially overlooking perfusion deficits in non-cerebral tissues.”