Kaimen Rigor reviewed

Rigor-Reviewed Manuscript

Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).

Name: Kaimen Rigor review — Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).
Item: Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).
Rating: 96
Author: Alpha1

Azuara-Blanco A, Logan NS, McConnell E, Kearney S, Kirk G, Jones S, McDowell C, Murphy L, O'Hanlon G, McFarland M, Painter S, Muthusamy B, Nabili S, Preston J, Flitcroft I, Loughman J, Mackey D, Lee S, Dahlmann-Noor A, Congdon N, Hogg RE, Hammond CJ, Saunders K, Allen PM, Strang N, Clarke M

Paper source

Read full text (PMC)

Embed this Rigor badge

Kaimen Rigor review — 2.25★ (Weak), 0 critical, 5 high issues for “Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).”

Links back to this Kaimen Rigor review.

Alpha1 Editorial

This rigor review was examined and confirmed by Alpha1 Editorial · August 15, 2026

Read alongside

Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).

Read full text (PMC)

DOI

10.1136/bmj-2025-086698

Share this Kaimen Rigor review

Post on X Share on LinkedIn Share via Email

Embed this Rigor badge

<a href="https://alpha1science.com/verify/9df7d526-6b07-4e74-a820-c5d799daf938" target="_blank" rel="noopener">
  <img src="https://alpha1science.com/verify/9df7d526-6b07-4e74-a820-c5d799daf938/badge" alt="Kaimen Rigor review — 2.25★ (Weak), 0 critical, 5 high issues for “Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).”" width="440" height="104" style="max-width:100%;height:auto" />
</a>

Every embed links back to this Kaimen Rigor review.

Record fingerprint

574e4760fd6bc0e7f8fd7bca2c0dbcd251f436f88a9c27da26073489de5a0672

Verify via API

Issued Aug 15, 2026Engine 7.39.0

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

Alpha¹ by Kaimen

Fetching the latest research

Kaimen Rigor reviewed

Rigor-Reviewed Manuscript

Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).

Paper source

Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).

Read full text (PMC)

Embed this Rigor badge

Links back to this Kaimen Rigor review.

Alpha1 Editorial

This rigor review was examined and confirmed by Alpha1 Editorial · August 15, 2026

Kaimen Rigor review

Kaimen Rigor reviewed

2.25 / 5

Weak — serious problems found

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern ×3−1.5★
ClaimsEfficacy rests on an unvalidated surrogate endpoint−0.5★
ClaimsTreatment effect not shown to be clinically meaningful−0.5★
ReportingData & code availability partially met−0.25★

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

Not verified in this report

No data or code availability links were detected to verify.

Biggest issues

01Efficacy rests on an unvalidated surrogate endpoint
highOverreachreviewer-assessedFull detail
The primary outcome is spherical equivalent refractive error (SER), a surrogate for myopia progression. The paper does not demonstrate target engagement at the tested dose (no PK/PD data) and does not cite validated evidence linking SER to the clinical outcome of myopia-related visual impairment. The claim of efficacy rests on this surrogate without establishing a validated surrogate-to-clinical-outcome link.
“The primary outcome was spherical equivalent refractive error of both eyes measured by autorefractor under cycloplegia after two years.”
Find in source
02Treatment effect not shown to be clinically meaningful
highOverreachreviewer-assessedFull detail
The reported effect size is a mean difference of 0.33 D in SER, which is small relative to the normal range of myopia progression and lacks an anchor to a minimal clinically important difference. The paper acknowledges the effect is small and does not provide a clinically meaningful threshold for this difference.
“The results of the CHAMP-UK trial indicate that atropine 0.01% eye drops were well tolerated and reduced the rate of myopia progression in children in a UK population, although the effect was small.”
Find in source

Findings by category

101ArithmeticNumerical inconsistencies 302OverreachOverstated conclusions 03AuthenticityNone found 104DisclosureReporting gaps 05AvailabilityNone found · partly checked 06Copyedit5 minor suggestions

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 well-reported randomised controlled trial with rigorous design, clear ethical approvals, and appropriate statistical methods. The main weakness is the incomplete data availability statement and lack of code sharing, which limits reproducibility. Minor copyedit issues (typos in tables) should be corrected.

Both reviewers independently scored all eight dimensions and agreed on every status; no divergence to reconcile. The statistics verification recomputed 5 tests, all consistent, but coverage is limited to tests with test statistics/CI; other reported statistics were not machine-verified. The citation check found no retracted or unresolved references.

Numerical inconsistencies

1 finding · worst low

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

Recomputed 5 tests: 5 consistent, 0 inconsistent; 5 via agent-written checks.

Overstated conclusions

3 findings · worst high

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

6 major claims checked against the paper's own evidence: 2 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.

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 a Cochrane review and multiple studies on atropine for myopia, acknowledging uncertainties and gaps in European populations. The rationale for the trial is clearly linked to the need for effective myopia control in the UK. The paper explicitly discusses limitations of previous studies, such as small sample sizes and lack of objective adherence measures, and addresses them in the current design.

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 with extensive prior work cited, a logical rationale, and addresses limitations of prior research.

Evidence

“A recent Cochrane review found that high concentration atropine (≥0.5%) may be the most effective treatment option, but the side effects (photophobia, blurred vision at near reading distance, and allergic reactions) render it unsuitable for routine clinical interventions to control myopia.”

Introduction ¶3Find in source

“In the CHAMP-UK (Childhood Atropine for Myopia Progression in the UK) study we evaluated the efficacy, safety, and mechanism of action of low concentration atropine (0.01%) in UK children with myopia aged 6 to 12 years.”

Introduction ¶4Find in source

“Limitations of previously published studies include smaller sample sizes and a lack of an objective measure of eye drop use, with typically calendar review and parental report used to record adherence to eye drop use.”

Discussion ¶5Find in source

PASSReviewer 2· 90% conf

The paper establishes a clear scientific premise with extensive prior work cited and a logical rationale for the trial.

Evidence

Introduction ¶2Find in source

Introduction ¶3Find in source

DiscussionFind in source

Randomization was computer-generated using a minimisation algorithm, with allocation concealed. Blinding was double-masked for participants and investigators. A detailed sample size calculation was provided. Inclusion/exclusion criteria were pre-specified. The analysis population (ITT and per-protocol) and missing data handling were defined. Controls (placebo) were appropriate. Independent replication is not applicable for a single pivotal trial.

Sub-criteria

controlsN/A

power analysisADEQUATE

blinding levelsADEQUATE

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 clear randomization, blinding, sample size calculation, and pre-specified inclusion/exclusion criteria.

Evidence

“Randomisation (2:1) was computer generated using a minimisation algorithm to ensure balanced allocation of participants across the two treatment groups.”

MethodsFind in source

“Investigators (chief, principal, and co-investigators), study monitors, and study participants were all masked throughout the study.”

MethodsFind in source

“With a standard deviation (SD) of 0.7, an intraclass correlation coefficient between the two eyes of 0.9, and a variation inflation factor of 1.9, we determined that we would need 228 participants (456 eyes).”

MethodsFind in source

PASSReviewer 2· 95% conf

The trial design is rigorous with clear randomisation, masking, sample size calculation, and pre-specified analysis populations.

Evidence

“Randomisation (2:1) was computer generated using a minimisation algorithm to ensure balanced allocation of participants across the two treatment groups.”

MethodsFind in source

“Investigators (chief, principal, and co-investigators), study monitors, and study participants were all masked throughout the study.”

MethodsFind in source

“Considering a dropout rate of 15% and that 10% of recruited children could be Chinese, we increased the number required to a total of 289 participants: 193 in the atropine group and 96 in the placebo group, to detect this difference in the non-Chinese UK population with 90% power.”

MethodsFind in source

Sex is reported for all participants (56% girls). Age, weight, and height are reported in Table 1. Demographics including ethnicity are detailed. Since both sexes are enrolled, sex_justified is not applicable. Species/strain and housing conditions are not applicable for a human trial.

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

Biological variables are well reported, including sex, age, weight, height, and ethnicity.

Evidence

“161 (56%) were girls”

AbstractFind in source

“Mean (SD) age (years) | 9.3 (1.7) | 9.3 (1.7) | 9.3 (1.7)”

Table 1Find in source

“White | 136 (701) | 71 (73) | 207 (72)”

Table 1Find in source

PASSReviewer 2· 90% conf

Biological variables are well reported for a human trial, including sex, age, weight, height, and ethnicity.

Evidence

“161 (56%) were girls”

AbstractFind in source

“Mean (SD) age (years) | 9.3 (1.7) | 9.3 (1.7) | 9.3 (1.7)”

Table 1Find in source

“White | 136 (701) | 71 (73) | 207 (72)”

Table 1Find in source

The study was approved by the Office for Research Ethics Committees Northern Ireland (reference 18/NI/0164). Informed consent is implied through the recruitment process ('After parental consent had been obtained'). Regulatory compliance is stated via adherence to the European Clinical Trials Directive and Good Clinical Practice.

Sub-criteria

iacuc statementN/A

informed consentADEQUATE

irb ethics statementADEQUATE

regulatory complianceADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 95% conf

Ethical approval is clearly documented with a named ethics committee and reference number, and informed consent is described.

Evidence

“CHAMP-UK (Childhood Atropine for Myopia Progression in the UK) was reviewed and approved by the Office for Research Ethics Committees Northern Ireland (reference 18/NI/0164).”

EthicsFind in source

“After parental consent had been obtained, children were screened and, if eligible, enrolled and randomised.”

MethodsFind in source

“Serious adverse events related to the use of the study drugs in the trial were reported in accordance with the guidance from the European Clinical Trials Directive 2001/20/EC”

MethodsFind in source

PASSReviewer 2· 95% conf

Ethical approval and consent are adequately reported.

Evidence

“CHAMP-UK (Childhood Atropine for Myopia Progression in the UK) was reviewed and approved by the Office for Research Ethics Committees Northern Ireland (reference 18/NI/0164).”

EthicsFind in source

“After parental consent had been obtained, children were screened and, if eligible, enrolled and randomised.”

MethodsFind in source

“Serious adverse events related to the use of the study drugs in the trial were reported in accordance with the guidance from the European Clinical Trials Directive 2001/20/EC”

MethodsFind in source

The study drug is identified as preserved atropine sulfate 0.01% eye drops, developed and supplied by Stockport Pharmaceuticals. The placebo is described with the same preservative and pH. Statistical software (Stata 15.1) is identified. Other bench resources are not applicable as this is a clinical trial.

Sub-criteria

mycoplasma testingN/A

reagents identifiedADEQUATE

organisms identifiedN/A

antibodies identifiedN/A

cell line authenticationN/A

software tools identifiedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The investigational product (atropine 0.01% eye drops) is identified with manufacturer and formulation, and the statistical software is identified.

Evidence

“The intervention group was assigned to receive preserved atropine sulfate 0.01% eye drops once daily at bedtime in both eyes for two years.”

MethodsFind in source

“The study drug was developed and supplied by Stockport Pharmaceuticals”

AcknowledgementsFind in source

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

Statistical analysisFind in source

PASSReviewer 2· 90% conf

The investigational product and key equipment are adequately identified.

Evidence

“The intervention group was assigned to receive preserved atropine sulfate 0.01% eye drops once daily at bedtime in both eyes for two years.”

MethodsFind in source

“Each site used the same type of autorefractor throughout the study (Grand Seiko Binocular Auto-refractor/Keratometer WR-5100 K, WAM-5500 or Shin-Nippon Accuref K-900; Grand Seiko, Hiroshima, Japan).”

MethodsFind in source

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

Statistical analysisFind in source

The primary analysis used GEE with 95% CIs, and p-values are reported exactly (e.g., P<0.001). Effect sizes are reported with CIs. Statistical software is identified. Data presentation includes per-group n and dispersion. Mathematical plausibility checks were not possible for all values due to continuous outcomes and model-based estimates, but no obvious errors were found.

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 compared the atropine and control groups using generalised estimating equations and 95% confidence intervals (CIs) to allow for the correlation between eyes within a participant.”

Statistical analysisFind in source

“mean difference 0.33 D, 95% confidence interval (CI) 0.17 to 0.49 D, P<0.001”

AbstractFind in source

“mean difference 0.14 mm (95% CI 0.07 to 0.21, P<0.001)”

AbstractFind in source

PASSReviewer 2· 90% conf

Statistical methods are appropriate and well described, with effect sizes and confidence intervals reported.

Evidence

“We compared the atropine and control groups using generalised estimating equations and 95% confidence intervals (CIs) to allow for the correlation between eyes within a participant.”

Statistical analysisFind in source

“mean difference 0.33 D, 95% confidence interval (CI) 0.17 to 0.49 D, P<0.001”

AbstractFind in source

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

Statistical analysisFind in source

The data availability statement is incomplete in the provided text (cut off). It likely states 'available on reasonable request' but lacks a concrete mechanism. No repository deposit or accession numbers are mentioned. Code sharing is not applicable as no custom code is described.

Sub-criteria

code sharingN/A

accession numbersN/A

repository depositNOT REPORTED

data availability statementINADEQUATE

Per reviewer (2) — the votes behind the verdict

WARNReviewer 1· 80% conf

A data availability statement is present but vague, and no code is shared.

Evidence

“The code used to analyse the data in the paper ca”

Data availabilityFind in source

WARNReviewer 2· 80% conf

A data availability statement is present but incomplete, and no code is shared.

Evidence

“The code used to analyse the data in the paper ca”

Data availabilityFind in source

The trial is registered (ISRCTN99883695, NCT03690089). Methods are detailed enough for replication. Limitations are discussed. Conclusions are proportional to the evidence. Funding and competing interests are declared. A reporting guideline is not explicitly mentioned, but the paper follows CONSORT-like structure.

Sub-criteria

funding coiADEQUATE

trial registrationADEQUATE

reporting guidelineNOT REPORTED

methods completenessADEQUATE

all outcomes reportedADEQUATE

limitations discussedADEQUATE

conclusions proportionalADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The manuscript is transparent with trial registration, detailed methods, limitations, and funding/COI statements.

Evidence

“Trial registration ISRCTN registry ISRCTN99883695, ClinicalTrials.gov NCT03690089”

AbstractFind in source

“A limitation of the current study is that as it is an efficacy trial, with adherence assessed by MEMS device, the generalisability of these findings to non-trial settings without the advantage of objective monitoring of adherence is unknown.”

LimitationsFind in source

“Funding: National Institute for Health and Care Research Efficacy and Mechanism Evaluation (project 15/48/59).”

FundingFind in source

PASSReviewer 2· 90% conf

The manuscript is transparent with trial registration, funding, COI, and limitations discussed.

Evidence

“Trial registration ISRCTN registry ISRCTN99883695, ClinicalTrials.gov NCT03690089”

AbstractFind in source

LimitationsFind in source

“Funding: National Institute for Health and Care Research Efficacy and Mechanism Evaluation (project 15/48/59).”

FundingFind in source

Registered (2 IDs: ClinicalTrials.gov, ISRCTN). No reporting guideline cited.

Broken references and links

None found · partly checked

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.

Nothing surfaced — but not everything feeding this category ran (missing: data/code link verification), so read this as a partial clean bill.

Checked 51 references by DOI: 47 verified — 4 no DOI (shown, not verified).

Copyediting

5 minor

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

No major wording or formatting errors. 5 minor suggestions below.

5 copyedit issues flagged: mostly consistency, typo, clarity.

Kaimen Rigor Action ItemsFinal pass before journal submission

The published work is robust and trustworthy, with minor reporting gaps. An informed reader should weigh the incomplete data availability statement and the absence of code sharing as limitations to reproducibility. The copyedit typos (e.g., 701% in Table 1) are minor but should be corrected in any erratum.

1.
HIGHcopyedit
Correct the impossible percentage in Table 1, Ethnicity row: change '136 (701)' to '136 (71)'.
A percentage of 701% is an obvious typo that undermines data credibility.
2.
HIGHcopyedit
Fix the missing minus sign in Table 5, Per protocol analysis, Severity of myopia: change '3.00 D or more' to '−3.00 D or more'.
The severity threshold is negative in myopia; the missing minus sign is an internal inconsistency.
3.
HIGHdata code
Complete the data availability statement in the manuscript to specify a concrete access route, such as a repository or a data access committee, with conditions and timeframe.
The current statement is truncated and does not meet clinical trial data-sharing standards.
4.
HIGHdata code
Deposit de-identified aggregate data or a data dictionary in a public repository (e.g., Dryad, Zenodo) and provide a persistent identifier.
Enhances transparency and reproducibility while respecting participant privacy.
5.
HIGHdata code
Provide the analysis code in a public repository (e.g., GitHub, Zenodo) with a DOI, as the current statement is truncated and no code link is given.
Code sharing is essential for reproducibility of the statistical analyses.
6.
MEDIUMreporting
Add a statement referencing the CONSORT reporting guideline and provide the checklist as supplementary material.
CONSORT is expected for randomised controlled trials and improves reporting completeness.
7.
MEDIUMcopyedit
Fix the missing closing parenthesis in Table 5, Per protocol analysis, Sex row: change '−0.35 (0.630; n=48' to '−0.35 (0.63); n=48'.
The current formatting is inconsistent and may confuse readers.
8.
LOWother
Clarify in the data availability statement that individual participant data are not publicly available due to privacy, and describe the process for requesting access.
Provides transparency about data access limitations.

Full text (58,189 chars)Analyzed: Aug 15, 2026

Start the discussion on JRNLClub

Community discussion on jrnlclub.com

Read alongside

Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).

Read full text (PMC)

DOI

10.1136/bmj-2025-086698

Share this Kaimen Rigor review

Post on X Share on LinkedIn Share via Email

Embed this Rigor badge

<a href="https://alpha1science.com/verify/9df7d526-6b07-4e74-a820-c5d799daf938" target="_blank" rel="noopener">
  <img src="https://alpha1science.com/verify/9df7d526-6b07-4e74-a820-c5d799daf938/badge" alt="Kaimen Rigor review — 2.25★ (Weak), 0 critical, 5 high issues for “Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).”" width="440" height="104" style="max-width:100%;height:auto" />
</a>

Every embed links back to this Kaimen Rigor review.

Record fingerprint

574e4760fd6bc0e7f8fd7bca2c0dbcd251f436f88a9c27da26073489de5a0672

Verify via API

Issued Aug 15, 2026Engine 7.39.0

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

Kaimen Rigor review

Kaimen Rigor reviewed

2.25 / 5

Weak — serious problems found

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern ×3−1.5★
ClaimsEfficacy rests on an unvalidated surrogate endpoint−0.5★
ClaimsTreatment effect not shown to be clinically meaningful−0.5★
ReportingData & code availability partially met−0.25★

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

Not verified in this report

No data or code availability links were detected to verify.

Biggest issues

01Efficacy rests on an unvalidated surrogate endpoint
highOverreachreviewer-assessedFull detail
The primary outcome is spherical equivalent refractive error (SER), a surrogate for myopia progression. The paper does not demonstrate target engagement at the tested dose (no PK/PD data) and does not cite validated evidence linking SER to the clinical outcome of myopia-related visual impairment. The claim of efficacy rests on this surrogate without establishing a validated surrogate-to-clinical-outcome link.
“The primary outcome was spherical equivalent refractive error of both eyes measured by autorefractor under cycloplegia after two years.”
Find in source
02Treatment effect not shown to be clinically meaningful
highOverreachreviewer-assessedFull detail
The reported effect size is a mean difference of 0.33 D in SER, which is small relative to the normal range of myopia progression and lacks an anchor to a minimal clinically important difference. The paper acknowledges the effect is small and does not provide a clinically meaningful threshold for this difference.
“The results of the CHAMP-UK trial indicate that atropine 0.01% eye drops were well tolerated and reduced the rate of myopia progression in children in a UK population, although the effect was small.”
Find in source

Findings by category

101ArithmeticNumerical inconsistencies 302OverreachOverstated conclusions 03AuthenticityNone found 104DisclosureReporting gaps 05AvailabilityNone found · partly checked 06Copyedit5 minor suggestions

Numerical inconsistencies

1 finding · worst low

Internal contradictions in the reported numbersAssessed

Recomputed 5 tests: 5 consistent, 0 inconsistent; 5 via agent-written checks.

Overstated conclusions

3 findings · worst high

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

6 major claims checked against the paper's own evidence: 2 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.

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· 90% conf

The paper establishes a clear scientific premise with extensive prior work cited, a logical rationale, and addresses limitations of prior research.

Evidence

Introduction ¶3Find in source

Introduction ¶4Find in source

Discussion ¶5Find in source

PASSReviewer 2· 90% conf

The paper establishes a clear scientific premise with extensive prior work cited and a logical rationale for the trial.

Evidence

Introduction ¶2Find in source

Introduction ¶3Find in source

DiscussionFind in source

Sub-criteria

controlsN/A

power analysisADEQUATE

blinding levelsADEQUATE

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 clear randomization, blinding, sample size calculation, and pre-specified inclusion/exclusion criteria.

Evidence

“Randomisation (2:1) was computer generated using a minimisation algorithm to ensure balanced allocation of participants across the two treatment groups.”

MethodsFind in source

“Investigators (chief, principal, and co-investigators), study monitors, and study participants were all masked throughout the study.”

MethodsFind in source

PASSReviewer 2· 95% conf

The trial design is rigorous with clear randomisation, masking, sample size calculation, and pre-specified analysis populations.

Evidence

“Randomisation (2:1) was computer generated using a minimisation algorithm to ensure balanced allocation of participants across the two treatment groups.”

MethodsFind in source

“Investigators (chief, principal, and co-investigators), study monitors, and study participants were all masked throughout the study.”

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

Biological variables are well reported, including sex, age, weight, height, and ethnicity.

Evidence

“161 (56%) were girls”

AbstractFind in source

“Mean (SD) age (years) | 9.3 (1.7) | 9.3 (1.7) | 9.3 (1.7)”

Table 1Find in source

“White | 136 (701) | 71 (73) | 207 (72)”

Table 1Find in source

PASSReviewer 2· 90% conf

Biological variables are well reported for a human trial, including sex, age, weight, height, and ethnicity.

Evidence

“161 (56%) were girls”

AbstractFind in source

“Mean (SD) age (years) | 9.3 (1.7) | 9.3 (1.7) | 9.3 (1.7)”

Table 1Find in source

“White | 136 (701) | 71 (73) | 207 (72)”

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· 95% conf

Ethical approval is clearly documented with a named ethics committee and reference number, and informed consent is described.

Evidence

“CHAMP-UK (Childhood Atropine for Myopia Progression in the UK) was reviewed and approved by the Office for Research Ethics Committees Northern Ireland (reference 18/NI/0164).”

EthicsFind in source

“After parental consent had been obtained, children were screened and, if eligible, enrolled and randomised.”

MethodsFind in source

“Serious adverse events related to the use of the study drugs in the trial were reported in accordance with the guidance from the European Clinical Trials Directive 2001/20/EC”

MethodsFind in source

PASSReviewer 2· 95% conf

Ethical approval and consent are adequately reported.

Evidence

“CHAMP-UK (Childhood Atropine for Myopia Progression in the UK) was reviewed and approved by the Office for Research Ethics Committees Northern Ireland (reference 18/NI/0164).”

EthicsFind in source

“After parental consent had been obtained, children were screened and, if eligible, enrolled and randomised.”

MethodsFind in source

“Serious adverse events related to the use of the study drugs in the trial were reported in accordance with the guidance from the European Clinical Trials Directive 2001/20/EC”

MethodsFind in source

Sub-criteria

mycoplasma testingN/A

reagents identifiedADEQUATE

organisms identifiedN/A

antibodies identifiedN/A

cell line authenticationN/A

software tools identifiedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The investigational product (atropine 0.01% eye drops) is identified with manufacturer and formulation, and the statistical software is identified.

Evidence

“The intervention group was assigned to receive preserved atropine sulfate 0.01% eye drops once daily at bedtime in both eyes for two years.”

MethodsFind in source

“The study drug was developed and supplied by Stockport Pharmaceuticals”

AcknowledgementsFind in source

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

Statistical analysisFind in source

PASSReviewer 2· 90% conf

The investigational product and key equipment are adequately identified.

Evidence

“The intervention group was assigned to receive preserved atropine sulfate 0.01% eye drops once daily at bedtime in both eyes for two years.”

MethodsFind in source

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

Statistical analysisFind in source

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 compared the atropine and control groups using generalised estimating equations and 95% confidence intervals (CIs) to allow for the correlation between eyes within a participant.”

Statistical analysisFind in source

“mean difference 0.33 D, 95% confidence interval (CI) 0.17 to 0.49 D, P<0.001”

AbstractFind in source

“mean difference 0.14 mm (95% CI 0.07 to 0.21, P<0.001)”

AbstractFind in source

PASSReviewer 2· 90% conf

Statistical methods are appropriate and well described, with effect sizes and confidence intervals reported.

Evidence

“We compared the atropine and control groups using generalised estimating equations and 95% confidence intervals (CIs) to allow for the correlation between eyes within a participant.”

Statistical analysisFind in source

“mean difference 0.33 D, 95% confidence interval (CI) 0.17 to 0.49 D, P<0.001”

AbstractFind in source

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

Statistical analysisFind in source

Sub-criteria

code sharingN/A

accession numbersN/A

repository depositNOT REPORTED

data availability statementINADEQUATE

Per reviewer (2) — the votes behind the verdict

WARNReviewer 1· 80% conf

A data availability statement is present but vague, and no code is shared.

Evidence

“The code used to analyse the data in the paper ca”

Data availabilityFind in source

WARNReviewer 2· 80% conf

A data availability statement is present but incomplete, and no code is shared.

Evidence

“The code used to analyse the data in the paper ca”

Data availabilityFind in source

Sub-criteria

funding coiADEQUATE

trial registrationADEQUATE

reporting guidelineNOT REPORTED

methods completenessADEQUATE

all outcomes reportedADEQUATE

limitations discussedADEQUATE

conclusions proportionalADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The manuscript is transparent with trial registration, detailed methods, limitations, and funding/COI statements.

Evidence

“Trial registration ISRCTN registry ISRCTN99883695, ClinicalTrials.gov NCT03690089”

AbstractFind in source

LimitationsFind in source

“Funding: National Institute for Health and Care Research Efficacy and Mechanism Evaluation (project 15/48/59).”

FundingFind in source

PASSReviewer 2· 90% conf

The manuscript is transparent with trial registration, funding, COI, and limitations discussed.

Evidence

“Trial registration ISRCTN registry ISRCTN99883695, ClinicalTrials.gov NCT03690089”

AbstractFind in source

LimitationsFind in source

“Funding: National Institute for Health and Care Research Efficacy and Mechanism Evaluation (project 15/48/59).”

FundingFind in source

Registered (2 IDs: ClinicalTrials.gov, ISRCTN). No reporting guideline cited.

Broken references and links

None found · partly checked

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.

Nothing surfaced — but not everything feeding this category ran (missing: data/code link verification), so read this as a partial clean bill.

Checked 51 references by DOI: 47 verified — 4 no DOI (shown, not verified).

Copyediting

5 minor

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

No major wording or formatting errors. 5 minor suggestions below.

5 copyedit issues flagged: mostly consistency, typo, clarity.

Kaimen Rigor Action ItemsFinal pass before journal submission

1.
HIGHcopyedit
Correct the impossible percentage in Table 1, Ethnicity row: change '136 (701)' to '136 (71)'.
A percentage of 701% is an obvious typo that undermines data credibility.
2.
HIGHcopyedit
Fix the missing minus sign in Table 5, Per protocol analysis, Severity of myopia: change '3.00 D or more' to '−3.00 D or more'.
The severity threshold is negative in myopia; the missing minus sign is an internal inconsistency.
3.
HIGHdata code
Complete the data availability statement in the manuscript to specify a concrete access route, such as a repository or a data access committee, with conditions and timeframe.
The current statement is truncated and does not meet clinical trial data-sharing standards.
4.
HIGHdata code
Deposit de-identified aggregate data or a data dictionary in a public repository (e.g., Dryad, Zenodo) and provide a persistent identifier.
Enhances transparency and reproducibility while respecting participant privacy.
5.
HIGHdata code
Provide the analysis code in a public repository (e.g., GitHub, Zenodo) with a DOI, as the current statement is truncated and no code link is given.
Code sharing is essential for reproducibility of the statistical analyses.
6.
MEDIUMreporting
Add a statement referencing the CONSORT reporting guideline and provide the checklist as supplementary material.
CONSORT is expected for randomised controlled trials and improves reporting completeness.
7.
MEDIUMcopyedit
Fix the missing closing parenthesis in Table 5, Per protocol analysis, Sex row: change '−0.35 (0.630; n=48' to '−0.35 (0.63); n=48'.
The current formatting is inconsistent and may confuse readers.
8.
LOWother
Clarify in the data availability statement that individual participant data are not publicly available due to privacy, and describe the process for requesting access.
Provides transparency about data access limitations.

Full text (58,189 chars)Analyzed: Aug 15, 2026