Efficacy and safety of anrikefon in patients with pruritus undergoing haemodialysis: multicentre, double blind, randomised placebo controlled phase 3 trial.
Liu BC, Li ZL, Zhang P, Zhong AM, Bai YL, Xu Y, Gao BH, Li YL, Wang Y, Zhou LH, Yao L, Wang JX, Yan R, Wang L, Liao B, Xie DQ, Yi XM, Guan TJ, Wang CL, Li GS, Li FQ, Chen JH, Anrikefon-302 study collaborator group
- DOI
- 10.1136/bmj-2025-085208
- Record issued
- 2026-08-15
- Engine
- 7.39.0
- Exported
- 2026-09-22
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How this rating was calculated
- 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★
- The numeric-impossibility checks (GRIM/GRIMMER/DEBIT/SPRITE) did not run: 6 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.
- No data or code availability links were detected to verify.
- 01Efficacy rests on an unvalidated surrogate endpoint
The primary endpoint is the WI-NRS score, a patient-reported symptom scale, which is a surrogate for the clinical outcome of pruritus. The paper does not provide evidence of target engagement at the tested dose (e.g., PK/PD data) nor does it cite validated evidence linking the WI-NRS score to a hard clinical outcome. The efficacy claim rests on this surrogate without such validation.
“The primary endpoint was the percentage of patients achieving at least a 4 point reduction in weekly mean 24 hour worst itching intensity numerical rating scale (WI-NRS) score from baseline to week 12.”
- 02Treatment effect not shown to be clinically meaningful
The primary effect is a 37% response rate in the anrikefon group versus 15% in placebo, with an odds ratio of 3.56. While statistically significant, the paper does not anchor this effect to a minimal clinically important difference or other clinical meaningfulness. The absolute difference is 22 percentage points, but no MCID is provided.
“37% of patients in the anrikefon group showed at least a 4 point reduction in WI-NRS score at week 12 compared with 15% in the placebo group (P<0.001).”
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 phase 3 randomised controlled trial with strong methodological rigor across most dimensions. The main weaknesses are the absence of a data availability statement and several minor internal inconsistencies in reported numbers that warrant correction.
Both reviewers classified the study as interventional and agreed on all dimension statuses. The statistics verification component recomputed only 4 of the reported tests/effect estimates (all consistent); the remaining statistics were not machine-verified. The copyedit pass flagged minor internal inconsistencies in participant counts and percentages.
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 4 tests: 4 consistent, 0 inconsistent; 4 via agent-written checks.
- CONSISTENTreported p < .001 · recomputed p = <.001Reviewers 1, 2Primary endpoint odds ratio p-value from reported OR and 95% CI
“The odds ratio for the anrikefon group versus placebo group was 3.56 (95% CI 2.30 to 5.50), with a P<0.001.”
Taken as given: The odds ratio is 3.56 with 95% CI 2.30 to 5.50.; The CI is two-sided at 95%.; The p-value is two-tailed.Method: Compute p-value from log odds ratio and its standard error derived from the CI.How we recomputed it: pCI(3.56, 2.30, 5.50, 1) - CONSISTENTreported p < .001 · recomputed p = <.001Reviewers 1, 2Secondary endpoint odds ratio p-value from reported OR and 95% CI
“The odds ratio for the anrikefon group versus placebo group was 3.34 (95% CI 2.29 to 4.87, P<0.001).”
Taken as given: The odds ratio is 3.34 with 95% CI 2.29 to 4.87.; The CI is two-sided at 95%.; The p-value is two-tailed.Method: Compute p-value from log odds ratio and its standard error derived from the CI.How we recomputed it: pCI(3.34, 2.29, 4.87, 1) - CONSISTENTreported p < .001 · recomputed p = <.001Reviewers 1, 2Between-group difference in Skindex-10 p-value from reported difference and 95% CI
“with a between group difference of −5.9 (95% CI −7.88 to −4.02, P<0.001).”
Taken as given: The difference is -5.9 with 95% CI -7.88 to -4.02.; The CI is two-sided at 95%.; The p-value is two-tailed.Method: Compute p-value from the difference and its standard error derived from the CI.How we recomputed it: pCI(-5.9, -7.88, -4.02, 0) - CONSISTENTreported p < .001 · recomputed p = <.001Reviewers 1, 2Between-group difference in 5-D itch p-value from reported difference and 95% CI
“with a between group difference of −2.2 (95% CI −2.77 to −1.62, P<0.001).”
Taken as given: The difference is -2.2 with 95% CI -2.77 to -1.62.; The CI is two-sided at 95%.; The p-value is two-tailed.Method: Compute p-value from the difference and its standard error derived from the CI.How we recomputed it: pCI(-2.2, -2.77, -1.62, 0)
- lowinternal contradictionThe text states 'The incidence of severe treatment emergent adverse events (CTCAE grade ≥3) was 42%, affecting four participants (1%)' which is internally inconsistent; 42% of 442 is ~186, not 4.
The incidence of severe treatment emergent adverse events (CTCAE grade ≥3) was 42%, affecting four participants (1%).
Resultsreviewer’s wording - lowinternal contradictionThe abstract reports 443 entered the open-label extension, but Table 3 lists n=442 for the open-label phase. This discrepancy is not explained.
443 subsequently entered the 40 week open label extension phase. ... Table 3 ... (n=442)
Table 3reviewer’s wording - lowinternal contradictionThe abstract states 243/275 (88%) completed, but 88% of 275 is 242, not 243. This is a minor rounding discrepancy.
“243/275 (88%) patients in the anrikefon group and 254/270 (94%) in the placebo group completed the 12 week double blind treatment.”
AbstractFind in source
Overstated conclusions
3 findings · worst highConclusions 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
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.
- partialReviewers 1, 2Anrikefon shows sustained long-term efficacy at week 40.The open-label extension showed persistent improvement, but without a control group, the claim of sustained efficacy is weakened.Evidence: At week 40, 356 participants showed persistent improvement in 5-D itch scale.
At week 40 of the open label extension phase, 356 participants showed a persistent improvement in quality of life scores on the 5-D itch scale, showing sustained efficacy of anrikefon.
Resultsreviewer’s wording - supportedReviewer 1Anrikefon results in a statistically significant reduction in itch intensity compared with placebo.The primary endpoint showed 37% vs 15% response, with OR 3.56 (95% CI 2.30-5.50, P<0.001), supporting the claim.Evidence: Primary endpoint results: 37% vs 15%, OR 3.56, P<0.001.
“37% of patients in the anrikefon group showed at least a 4 point reduction in WI-NRS score at week 12 compared with 15% in the placebo group (P<0.001).”
AbstractFind in source - supportedReviewer 1Anrikefon improves itch-related quality of life.Significant improvements in Skindex-10 and 5-D itch scales were reported with between-group differences and CIs excluding zero.Evidence: Skindex-10 difference -5.9 (95% CI -7.88 to -4.02); 5-D itch difference -2.2 (95% CI -2.77 to -1.62).
The anrikefon group showed significant improvements in itch related quality of life at week 12 using the Skindex-10 and 5-D itch scales compared with placebo group.
Resultsreviewer’s wording - supportedReviewer 1Anrikefon is safe and well tolerated.Adverse event rates were comparable between groups, with dizziness more common but mild to moderate. No serious safety signals were identified.Evidence: TEAE incidence 83% vs 82%; serious AEs 13% vs 13%; deaths 1% vs 2%.
“During the double blind treatment phase, the incidence of treatment emergent adverse events was comparable between the anrikefon and placebo groups [228 (83%) and 222 (82%) participants, respectively].”
Table 2Find in source - supportedReviewer 2Anrikefon is safe and results in a noticeable reduction in itch intensity and improvement in itch-related quality of life in patients with moderate to severe pruritus undergoing haemodialysis.The primary and secondary endpoints show statistically significant improvements with anrikefon, and safety data show comparable adverse events with placebo.Evidence: Primary endpoint: 37% vs 15% (P<0.001); secondary endpoints: 51% vs 24% (P<0.001); quality of life improvements; safety data in Tables 2 and 3.
“In patients with moderate to severe pruritus undergoing haemodialysis, anrikefon was found to be safe and resulted in a noticeable reduction in itch intensity and an improvement in itch related quality of life.”
ConclusionFind in source - supportedReviewer 2Anrikefon's efficacy with a lower treatment dose was comparable to that of difelikefalin.The paper reports a response rate of 37.2% for anrikefon vs 37.1% for difelikefalin, directly supporting comparability.Evidence: Discussion: 'anrikefon’s efficacy with a lower treatment dose was comparable to that of difelikefalin (37.2% v 37.1%)'
“Importantly, the present phase 3 trial showed that anrikefon’s efficacy with a lower treatment dose was comparable to that of difelikefalin (37.2% v 37.1%) in treating pruritus in patients undergoing haemodialysis.”
DiscussionFind in source - supportedReviewer 2Anrikefon is well tolerated with prolonged use.Safety data from the open-label phase show no increase in adverse events with longer use, and no dysphoria or hallucination events were observed.Evidence: Discussion: 'the treatment emergent adverse events did not increase with prolonged use of anrikefon' and 'no dysphoria or hallucination events were observed'
“Importantly, the treatment emergent adverse events did not increase with prolonged use of anrikefon.”
DiscussionFind in source
Premise concern: surrogate not validated for clinical benefit; effect size not shown to be clinically meaningful.
- INADEQUATESurrogate endpointThe primary endpoint is the WI-NRS score, a patient-reported symptom scale, which is a surrogate for the clinical outcome of pruritus. The paper does not provide evidence of target engagement at the tested dose (e.g., PK/PD data) nor does it cite validated evidence linking the WI-NRS score to a hard clinical outcome. The efficacy claim rests on this surrogate without such validation.
“The primary endpoint was the percentage of patients achieving at least a 4 point reduction in weekly mean 24 hour worst itching intensity numerical rating scale (WI-NRS) score from baseline to week 12.”
- INADEQUATEEffect sizeThe primary effect is a 37% response rate in the anrikefon group versus 15% in placebo, with an odds ratio of 3.56. While statistically significant, the paper does not anchor this effect to a minimal clinically important difference or other clinical meaningfulness. The absolute difference is 22 percentage points, but no MCID is provided.
“37% of patients in the anrikefon group showed at least a 4 point reduction in WI-NRS score at week 12 compared with 15% in the placebo group (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
1 finding · worst mediumRequired 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
The paper cites prior work on the prevalence and impact of CKD-associated pruritus, the role of kappa/mu opioid receptor imbalance, and a previous phase 2 trial of anrikefon showing clinically meaningful reductions in itch intensity. The rationale logically links the premise to the study objectives, and the limitations of prior research (e.g., need for phase 3 confirmation) are addressed by conducting this trial.
“A previous phase 2 trial involving patients receiving haemodialysis and with moderate to severe pruritus showed clinically meaningful reductions in itch intensity and statistically significant improvements in itch related quality of life in the anrikefon group compared with placebo group.”
“Notably, the imbalance between kappa opioid receptor and mu opioid receptor signalling is considered to play a crucial role in the development of pruritus.”
“We conducted a phase 3 trial to evaluate the efficacy and safety of anrikefon in patients with moderate to severe pruritus undergoing haemodialysis.”
“CKD associated pruritus affects more than 60% of patients undergoing haemodialysis, with 33-50% reporting moderate to severe itching.”
“the imbalance between kappa opioid receptor and mu opioid receptor signalling is considered to play a crucial role in the development of pruritus.”
“A previous phase 2 trial involving patients receiving haemodialysis and with moderate to severe pruritus showed clinically meaningful reductions in itch intensity”
Randomisation used a computer-generated sequence with stratification by baseline WI-NRS score. Blinding is described (double-blind). A sample size calculation was performed based on phase 2 data, with a one-sided test, alpha 0.025, power 80%, and a 20% dropout adjustment. Inclusion/exclusion criteria are described, and the analysis population (full analysis set) and missing data handling (multiple imputation) are pre-specified. The trial is a human RCT, so replicate_distinction, controls, and independent_replication are not applicable.
“Randomisation and blinding were performed using a computer generated sequence and stratified by baseline WI-NRS score (<7 (moderate itching) and ≥7 (severe itching)) to ensure that the groups were well balanced for disease severity.”
“Using a one sided test with a significance level of 0.025 and a power of 80%, a total of 434 participants were required to detect a difference in the primary endpoint. Considering a 20% dropout rate, we aimed to enrol study 544 participants.”
“Eligible patients for the double blind phase were adults (≥18 years) undergoing haemodialysis three times weekly for at least three months, with a dry body weight (ie, patients neither overhydrated or underhydrated, as determined by the doctor) of 40-135 kg and moderate to severe pruritus.”
“Randomisation and blinding were performed using a computer generated sequence and stratified by baseline WI-NRS score (<7 (moderate itching) and ≥7 (severe itching))”
“Using a one sided test with a significance level of 0.025 and a power of 80%, a total of 434 participants were required to detect a difference in the primary endpoint.”
“data handling according to the multiple imputation strategy for missing data”
The study reports sex (70% men), mean age (52.7 years), and baseline WI-NRS scores. Since both sexes are enrolled, sex_justified is not applicable. Age, weight, and health status are reported in Table 1. Demographics are adequately reported. Species/strain and housing conditions are not applicable for a human trial.
“The study population comprised predominantly men (70%), with a mean age of 52.7 years.”
“The baseline weekly mean WI-NRS score was 7.0 (standard deviation (SD 1.1).”
The paper states approval by the ethics committee of the Clinical Research of the First Affiliated Hospital to Zhejiang University School of Medicine (approval No 2022-177), Zhongda Hospital Affiliated to Southeast University School of Medicine (approval No 2021ZDSYLL318-Y01), and all other participating centres. Written informed consent was obtained from all participants. Compliance with the Declaration of Helsinki and Good Clinical Practice guidelines is stated.
“This study was approved by the ethics committee of the Clinical Research of the First Affiliated Hospital to Zhejiang University School of Medicine (approval No 2022-177), Zhongda Hospital Affiliated to Southeast University School of Medicine (approval No 2021ZDSYLL318-Y01), and all other participating centres.”
“All participants provided written informed consent before trial participation.”
“This trial was also conducted in accordance with the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines.”
“This study was approved by the ethics committee of the Clinical Research of the First Affiliated Hospital to Zhejiang University School of Medicine (approval No 2022-177), Zhongda Hospital Affiliated to Southeast University School of Medicine (approval No 2021ZDSYLL318-Y01)”
“All participants provided written informed consent before trial participation.”
“This trial was also conducted in accordance with the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines.”
Anrikefon is named as the investigational drug, with dose (0.3 μg/kg) and regimen (three times weekly). The manufacturer (Haisco Pharmaceutical Group) is mentioned in funding. Statistical software (SAS version 9.4) is identified. Other bench resources (antibodies, cell lines, etc.) are not applicable.
“Intravenous anrikefon (0.3 μg/kg body weight) or placebo three times weekly for 12 weeks”
“All statistical analyses were performed using SAS software (version 9.4).”
“Intravenous anrikefon (0.3 μg/kg body weight) or placebo three times weekly for 12 weeks”
“All statistical analyses were performed using SAS software (version 9.4).”
The primary analysis uses logistic regression with multiple imputation, and secondary endpoints use mixed effects models. Tests are named (χ² test, analysis of covariance). Exact p-values are reported (e.g., P<0.001). Effect sizes with confidence intervals are provided. Software is identified. Data presentation includes per-group n and confidence intervals. Mathematical plausibility checks are not applicable due to large sample size and continuous outcomes.
“For each imputed complete dataset, a logistic regression model was applied, using at least a 4 point change from baseline to week 12 in the weekly mean WI-NRS score as the dependent variable, the treatment group as the independent variable, and the baseline WI-NRS score as a covariate.”
“P values were calculated using χ 2 test (A and B) and analysis of covariance (C and D).”
“For each imputed complete dataset, a logistic regression model was applied”
“with a P<0.001”
“The odds ratio for the anrikefon group versus placebo group was 3.56 (95% CI 2.30 to 5.50)”
The paper does not include an explicit data availability statement in the main text. The supplementary appendix is mentioned but not a repository. No accession numbers or code repository are provided. For a clinical trial, managed access is acceptable, but the absence of any statement is a gap.
“The lead author (the manuscript’s guarantor) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported”
Trial registration number is provided (NCT05135390). Methods are comprehensive. Limitations are explicitly discussed. Conclusions are proportional to the evidence. Funding and competing interests are declared. No reporting guideline checklist is mentioned, but this is not a fail.
“Trial registration ClinicalTrials.gov NCT05135390 .”
“This study has several limitations. Firstly, it exclusively enrolled patients with end stage renal disease requiring haemodialysis.”
“Funding: This trial was funded by the Haisco Pharmaceutical Group.”
“ClinicalTrials.gov NCT05135390”
“This study has several limitations. Firstly, it exclusively enrolled patients with end stage renal disease requiring haemodialysis.”
“This trial was funded by the Haisco Pharmaceutical Group.”
Registered (1 ID: ClinicalTrials.gov). No reporting guideline cited.
Broken references and links
None found · partly checkedReferences 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 26 references by DOI: 24 verified — 2 no DOI (shown, not verified).
- NO DOIMedical Dictionary for Regulatory Activities (MedDRA)No DOI in the reference — shown for manual review; not independently verifiable (not a fabrication signal).
- NO DOICommon Terminology Criteria for Adverse Events (CTCAE)No DOI in the reference — shown for manual review; not independently verifiable (not a fabrication signal).
Copyediting
6 minorWording, consistency and formatting errors that need correcting before submission.
No major wording or formatting errors. 6 minor suggestions below.
6 copyedit issues flagged: mostly consistency, clarity, typo.
- MINORtypoAuthor list“Liu Bi-Cheng professor Li Zuo-Lin consultant nephrologist”→ Format author names and affiliations consistently.Author names and titles are run together.
- MINORconsistencyResults, Trial participants“The study population comprised predominantly men (70%), with a mean age of 52.7 years.”→ Ensure consistency with Table 1 which reports mean age 51.8 and 53.6 for groups.Overall mean age may be a weighted average, but it is not explicitly calculated.
- MINORclarityResults, Drug use and adverse events“The incidence of severe treatment emergent adverse events (CTCAE grade ≥3) was 42%, affecting four participants (1%).”→ Clarify the denominator for the 42% figure.42% of 442 is 186, not 4; likely a typo.
- MINORconsistencyAbstract, Results“243/275 (88%) patients in the anrikefon group and 254/270 (94%) in the placebo group completed the 12 week double blind treatment.”→ Ensure the percentages are consistent with the numbers (88% of 275 is 242, not 243; 94% of 270 is 254).Minor rounding discrepancy.
- MINORclarityResults, Drug use and adverse events“The incidence of severe treatment emergent adverse events (CTCAE grade ≥3) was 42%, affecting four participants (1%).”→ Clarify the denominator for the 42% figure; it likely refers to the open-label phase, but the sentence is ambiguous.Ambiguous percentage.
- MINORconsistencyTable 3“Open label phase | No (%) of participants (n=442)”→ Ensure the n=442 matches the text that states 443 entered the open-label phase.Potential inconsistency in participant count.
The published work is robust in design and reporting, but readers should weigh the missing data availability statement and the minor internal inconsistencies (e.g., adverse event percentage, open-label participant count) as limitations. These issues do not undermine the primary efficacy findings but warrant clarification or an erratum.
- 1.HIGHdata codeAdd a data availability statement in the 'Transparency' section specifying how de-identified participant data can be accessed (e.g., via a data access committee or repository) with conditions and timeframe.The absence of a data availability statement is a reporting gap that limits reproducibility and transparency.
- 2.HIGHstatisticsCorrect the internal inconsistency in the adverse events sentence: 'The incidence of severe treatment emergent adverse events (CTCAE grade ≥3) was 42%, affecting four participants (1%)' — clarify the denominator and correct the percentage or the count.The current statement is internally contradictory (42% of 442 is ~186, not 4) and could mislead readers.
- 3.HIGHreportingReconcile the open-label phase participant count: the abstract states 443 entered the open-label extension, but Table 3 lists n=442; correct the discrepancy.Inconsistent participant counts across sections undermine confidence in the reported data.
- 4.MEDIUMreportingCorrect the rounding discrepancy in the abstract: 243/275 (88%) should be 242/275 (88%) or adjust the numerator to match the percentage.Minor arithmetic inconsistency in a headline completion rate.
- 5.MEDIUMreportingClarify the overall mean age in the Results text (52.7 years) versus Table 1 group means (51.8 and 53.6) by stating it is a weighted average or correcting the text.Readers may question the consistency of reported demographic data.
- 6.MEDIUMreportingMention adherence to CONSORT reporting guidelines in the methods or acknowledgements, and consider submitting the CONSORT checklist as supplementary material.Explicitly following a reporting guideline enhances transparency and completeness.
- 7.MEDIUMdata codeConsider depositing the statistical analysis code (e.g., SAS code) in a public repository like Zenodo or GitHub with a DOI to enhance reproducibility.Sharing analysis code allows independent verification of the statistical methods.
- 8.MEDIUMreportingClarify the role of the funder in the trial design, conduct, analysis, and reporting, as the current funding statement is brief.Transparency about funder involvement is important for assessing potential bias.
- 9.LOWreportingProvide more detail on the open-label extension phase's analysis methods, including how missing data were handled and the statistical model used for the 5-D itch scale at week 40.Additional methodological detail would improve the completeness of the report.
- 10.LOWcopyeditFormat author names and affiliations consistently in the author list (e.g., 'Liu Bi-Cheng professor Li Zuo-Lin consultant nephrologist' should be separated).Consistent formatting improves professionalism and readability.
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.
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