Risk of infection and wound dehiscence after use of prophylactic antibiotics in episiotomy or second degree tear (REPAIR study): single centre, double blind, placebo controlled randomised trial.

Name: Αlpha¹ Rigor Record — Risk of infection and wound dehiscence after use of prophylactic antibiotics in episiotomy or second degree tear (REPAIR study): single centre, double blind, placebo controlled randomised trial.
Item: Risk of infection and wound dehiscence after use of prophylactic antibiotics in episiotomy or second degree tear (REPAIR study): single centre, double blind, placebo controlled randomised trial.
Rating: 59
Author: Αlpha¹

Perslev K, Klarskov N, Bergholt T, Jangö H

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Αlpha¹ Rigor Review — 3.25★ (Adequate), 0 critical, 3 high issues for “Risk of infection and wound dehiscence after use of prophylactic antibiotics in episiotomy or second degree tear (REPAIR study): single centre, double blind, placebo controlled randomised trial.”

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Αlpha¹ Editorial

This rigor review was examined and confirmed by Αlpha¹ Editorial · August 10, 2026

Αlpha¹ Rigor Review

Rigor Reviewed

Incomplete run — read this verdict with care

Only 2 of 3 reviewers completed. Each verdict below is the majority of 2, not of 3 — the disagreement between reviewers that normally filters out one model's noise could not be applied.
This run hit its time budget: at least one step billed work that never produced a result.

3.25 / 5

Adequate — real issues to address

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern ×2−1★
ReportingKey resources partially met−0.25★
ReportingStatistical analysis partially met−0.25★
ReportingData & code availability partially met−0.25★

Model-reported confidence: moderateReviewer agreement: highEngine: 7.29.0Source: full text

Problems surfaced5 types

Overstated conclusions1

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.

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

Reporting gaps3

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.

Statistical reporting gaps (tests, assumptions, effect sizes)Assessed
Data/code availability incompleteAssessed
Key resources under-identified (antibodies, cell lines, RRIDs)Assessed

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.

The REPAIR trial is a methodologically strong, well-designed double-blind placebo-controlled RCT with rigorous randomisation, blinding, power analysis, transparent reporting, dual registration, CONSORT adherence, and openly available data. The main weaknesses are reporting gaps rather than validity threats: the investigational drug manufacturer is not stated, one p-value is reported only as a threshold, the analysis code is only in supplemental files, and registration was retrospective with the headline recommendation resting on a secondary outcome added after study initiation.

Two independent reviewer runs were reconciled; they agreed on six dimensions and diverged on statistical analysis (warn vs pass) and on the demographics sub-criterion (ethnicity). The statistics verification recomputed only 4 tests reported with test statistics/df or effect estimates with CIs (all consistent); threshold-only, exact/permutation p-values and GRIM/GRIMMER checks (inapplicable to continuous measurements) are not verified. All 22 references were located with none retracted, and both data links are live. Criteria not applicable to a human obstetric drug trial were excluded.

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

Efficacy claim is anchored to an adequate endpoint and a meaningful effect.

Recomputed 4 tests: 4 consistent, 0 inconsistent; 4 via agent-written checks.

2 integrity concerns flagged (0 high).

Reporting

Eight Dimensions5 pass · 3 warn

Prior work is cited with explicit acknowledgment of limitations (e.g., high loss to follow-up, lack of placebo control, methodological weaknesses). The rationale linking the evidence gap to the study objective is explicit, and the design addresses prior limitations (e.g., placebo control, defined outcomes, low drop-out rate).

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The introduction clearly establishes the scientific gap, cites prior work (Cochrane reviews, ANODE trial), and logically motivates the study hypothesis.

Evidence

direct quote[Introduction, paragraph 2]

“A Cochrane review evaluated prophylactic antibiotics for obstetric anal sphincter injury, but included only one randomised controlled trial, which reported a reduction in healing complications from 24% to 8% following a single intravenous dose of antibiotics. The loss to follow-up was high, prompting the authors to recommend cautious data interpretation.”