{
  "topic": "addiction-brain-disease",
  "completed": true,
  "provider_mode": "Consensus Pro browser-thread with raw response preserved; Consensus keyword search discovery plus PubMed original-source checks",
  "queries": [
    "Do drug-induced neural adaptations cause loss of volitional control and a generally chronic relapsing course in human substance use disorders? Primary evidence from human lesion studies, prospective outcome prediction, contingency management and natural recovery; distinguish brain involvement from universal loss of agency.",
    "prospective longitudinal study neurocognition predicts relapse remission substance use disorder human addiction objective outcomes"
  ],
  "raw_paths": [
    "deliverables/consensus_consistency_audit_2026-10-09/checks/addiction-brain-disease/consensus-browser-response.md",
    "deliverables/consensus_consistency_audit_2026-10-09/checks/addiction-brain-disease/browser-thread.json",
    "deliverables/consensus_consistency_audit_2026-10-09/checks/addiction-brain-disease/consensus-search-leads.md",
    "deliverables/consensus_consistency_audit_2026-10-09/checks/addiction-brain-disease/consensus-addendum.md"
  ],
  "primary_comparisons": [
    {
      "pmid": "35697842",
      "doi": "10.1038/s41591-022-01834-y",
      "access_depth": "abstract/figure-caption",
      "result": "Human focal-lesion cohorts associate network disruption with smoking-addiction remission; anatomically heterogeneous, network mapping, not drug-induced adaptation or general SUD necessity.",
      "grade_changed": false
    },
    {
      "pmid": "37567334",
      "doi": "10.1016/j.biopsych.2023.07.020",
      "access_depth": "abstract_metadata",
      "result": "One prospective stimulant cohort found anterior-insula loss-anticipation response predicted relapse; association, not mediator manipulation; no group difference in marker reported.",
      "grade_changed": false
    },
    {
      "pmid": "27442691",
      "doi": "10.1037/adb0000192",
      "access_depth": "abstract_metadata plus archived partial full-text receipt",
      "result": "Randomized contingency-management trial showed context-sensitive retention/abstinence, with negative-sample proportion sensitive to expected-vs-submitted denominator; already counted in archive.",
      "grade_changed": false
    },
    {
      "access_depth": "abstract_metadata",
      "doi": "10.1111/add.15349",
      "pmid": "33220122",
      "grade_changed": false,
      "result": "2x2 RCT: incentives increased alcohol-negative EtG sample submission; drug-abstinence result inconclusive under multiple imputation. Not in original inventory."
    }
  ],
  "conclusion": "No SC1, SC2, SC3, or aggregate score/confidence change; overall remains Γ/Moderate. Joutsa lesion-network supports bounded circuit involvement, not the broad drug-induced-adaptation claim. MacNiven supplies single-cohort prediction, not causal mediation. Existing Miguel CM and newly verified McDonell CM trials show contingency-sensitive measured outcomes, not volition or brain independence. Prior score visible; not blind.",
  "addendum_path": "deliverables\\consensus_consistency_audit_2026-10-09\\checks\\addiction-brain-disease\\consensus-addendum.md",
  "grade_changed": false,
  "additional_original_source_receipts": [],
  "primary_comparison_count": 4,
  "status": "completed_retrospective_original_source_reconciliation",
  "score_before": {
    "hsef_level": "Γ",
    "hsef_descriptor": "Mechanistically plausible, partial system support",
    "confidence": "Moderate",
    "confidence_rationale": "56 primary reports with 2 selected partial-body examinations; density, heterogeneous controls and incomplete access set the confidence, not correctness.",
    "rests_on_non_peer_reviewed_work": false,
    "rationale": "Overall Γ follows SC3. Specific experimental neural effects, clinical treatment responses and recovery trajectories support a biological/behavioral disorder with context-dependent control. They do not establish that persistent neuroadaptations generally remove voluntary control or make chronic relapse the necessary course."
  },
  "score_after": {
    "hsef_level": "Γ",
    "hsef_descriptor": "Mechanistically plausible, partial system support",
    "confidence": "Moderate",
    "confidence_rationale": "56 primary reports with 2 selected partial-body examinations; density, heterogeneous controls and incomplete access set the confidence, not correctness.",
    "rests_on_non_peer_reviewed_work": false,
    "rationale": "Overall Γ follows SC3. Specific experimental neural effects, clinical treatment responses and recovery trajectories support a biological/behavioral disorder with context-dependent control. They do not establish that persistent neuroadaptations generally remove voluntary control or make chronic relapse the necessary course."
  },
  "raw_receipts": [
    {
      "path": "deliverables\\consensus_consistency_audit_2026-10-09\\checks\\addiction-brain-disease\\consensus-browser-response.md",
      "sha256": "e838c27992019a1ea8423caf602e4b75e859494338e221a224ab0a88f69ad8db"
    },
    {
      "path": "deliverables\\consensus_consistency_audit_2026-10-09\\checks\\addiction-brain-disease\\browser-thread.json",
      "sha256": "f4d09abe7f5230046e2ceae8d0620b8a80c93f53ae764061e15be0cd8005846f"
    },
    {
      "path": "deliverables\\consensus_consistency_audit_2026-10-09\\checks\\addiction-brain-disease\\consensus-search-leads.md",
      "sha256": "2a33466402190d803fc0bbd83ffb40e98505b76d5b1c329bad1ba4925a366f3f"
    },
    {
      "path": "deliverables\\consensus_consistency_audit_2026-10-09\\checks\\addiction-brain-disease\\consensus-addendum.md",
      "sha256": "372902364da888c232683c30ba7cb27e3d0a13ee893961e2362897d5ca59f15c"
    }
  ],
  "manifest_source": "deliverables\\consensus_consistency_audit_2026-10-09\\checks\\addiction-brain-disease\\structured-consensus-validation.json",
  "literature_cutoff_preserved": true,
  "independent_blinded_audit": false
}