{
  "slug": "bpc-157-tissue-repair",
  "round": 2,
  "group": 7,
  "date": "2026-10-14",
  "authoring_model": "Sol 6.1",
  "adversarial_reviewer": "Claude Opus 5.5 (Anthropic)",
  "canonical_path": "consensus_consistency_audit_2026-10-09/revised/bpc-157-tissue-repair/bpc-157-tissue-repair.review.md",
  "edition_note": "Revised edition carrying the 9 October 2026 Consensus provenance supplement and claim-register repair; reviewed as it now stands.",
  "propagate_to": [],
  "divergent_copies": [],
  "level_before": "Γ",
  "level_after": "Γ",
  "confidence_before": "Low",
  "confidence_after": "Low",
  "role_before": "epiphenomenon (human scope); reinforcing / stabilizing factor (rat scope)",
  "role_after": "unchanged",
  "pmids_checked": 18,
  "pmids_failed": 0,
  "retractions_or_eoc_found": 0,
  "claims_spot_checked": 12,
  "validator": {
    "before": "PASS — 0 fail, 0 warn, 34 pass",
    "after": "PASS — 0 fail, 0 warn, 34 pass",
    "note": "Genuine v5.4 package, so validator 2.4 passes cleanly; this is the only case in group 7 without the lay-summary version mismatch."
  },
  "findings": [
    {
      "id": "AR-1",
      "severity": "Major",
      "type": "false_provenance",
      "location": ["Consensus provenance reconciliation block", "consensus-addendum.md"],
      "original": "The earlier adversarial approval refers to its original edition; this provenance supplement is not a new independent or blinded adjudication.",
      "corrected": "No earlier adversarial approval is attached to this case; the 2026-10-06 adversarial pass did not cover it, and this provenance supplement is not a new independent or blinded adjudication.",
      "evidence": "Clause inserted unconditionally by the 9 October revision script. Verified against the corpus: 56 review files carry a 2026-10-06 approval banner and this case is not among them, and no earlier edition of this review carries an approval section."
    },
    {
      "id": "AR-2",
      "severity": "Minor",
      "type": "revision_inconsistency",
      "location": ["LIMITATIONS OF THIS REVIEW, second bullet"],
      "original": "- The pharmacokinetic content of the intravenous pilot [1] could not be checked against the primary report (claim C19, unverified).",
      "corrected": "Sentence scoped: human pharmacokinetics remains unresolved, and the non-scoring claim C19 that formerly carried this description was retired from the scored register on 2026-10-09, so it is no longer an unverified entry.",
      "evidence": "The 9 October claim-register repair retired C19; the score card's register runs C1 to C18 with no C19, and the provenance header reports 0 unverified. The preserved sentence pointed at a claim ID that no longer exists. Fixed by scoping rather than deleting, preserving the substantive limitation."
    },
    {
      "id": "AR-3",
      "severity": "Minor",
      "type": "false_provenance",
      "location": ["Claim-register repair note"],
      "original": "The original approval predates this repair.",
      "corrected": "No earlier adversarial approval is attached to this case.",
      "evidence": "Same false-approval artifact as AR-1, in a second location."
    }
  ],
  "rejected_findings": [
    {
      "id": "RJ-1",
      "claim": "The level or the aggregation rule is wrong.",
      "resolution": "Rejected. Weakest-link is pre-registered and justified by the conjunctive claim form; all four human-scope gates are Gamma; SC5 is scored at rat scope and marked non-gating under the quoted cap-precedence rule; all three rules return Gamma. Delta fails for want of a controlled human perturbation with a structural endpoint; Beta fails because controlled rat perturbations from outside the originating programme supply mechanistic content. SC5 at Delta rather than Epsilon is correct because the boundary is untested, not mapped."
    },
    {
      "id": "RJ-2",
      "claim": "The 'epiphenomenon' role label misleads a reader into thinking BPC-157 is inactive.",
      "resolution": "Rejected. It is the framework's step-2 label applied at the claimed human scope, glossed in plain language in both AT A GLANCE and the lay summary, with 'reinforcing / stabilizing factor' recorded separately at rat scope."
    },
    {
      "id": "RJ-3",
      "claim": "The renderer bug prints the nominal model as the best-supported rival.",
      "resolution": "Rejected for this case. models_evaluated[0] is M2 with is_nominal false and tournament rank 1; the nominal M1 ranks third, and the prose names M2."
    },
    {
      "id": "RJ-4",
      "claim": "The provenance block back-dates PMID 42542926 into a 5 October ledger although the red-team note calls it newly added evidence.",
      "resolution": "Rejected. The 5 October enrichment artifacts (research-update-2026-10-05.bib and enrichment.json) contain all eleven listed identifiers, PMID 42542926 among them."
    },
    {
      "id": "RJ-5",
      "claim": "The confidence band is set from the reviewer's access depth rather than from evidence density.",
      "resolution": "Rejected. Low is justified by quoting the framework's Low text and naming the single connected research programme. This is the one case in group 7 whose band rests on density and replication rather than access."
    },
    {
      "id": "RJ-6",
      "claim": "A preserved reviewer note contradicts the spliced Consensus block.",
      "resolution": "Rejected. No preserved sentence in this review makes any claim about Consensus use, so there is nothing for the spliced block to contradict."
    },
    {
      "id": "RJ-7",
      "claim": "The bladder pilot's positive result is under-reported (complete resolution in 10 of 12, 5 of 5 GRA in all 12).",
      "resolution": "Rejected. The review's point is that an uncontrolled, single-procedure, local, symptomatic study of a different organ cannot bear on the registered claim, and competing model M3 states that account explicitly. Quoting the response rate without a comparator would invite the inference the review declines to license."
    }
  ],
  "benefit_risk_audit": {
    "absolute_vs_relative_errors": 0,
    "population_errors": 0,
    "safety_overclaims": 0,
    "safety_underclaims": 0,
    "lay_summary_compliance": "No dosing, sourcing or practical advice; no safety claim the review did not assess; grade restated rather than re-argued.",
    "checked": [
      "40131143 two participants, 10 then 20 mg IV, vitals and blood chemistry, no plasma concentrations, no injury or comparator",
      "34324435 one-year retrospective chart review, 16 of 17 reached, 11/12 and 3/4 reporting significant improvement, recalled pain, no control, no imaging",
      "39325560 12 pentosan-refractory women, peri-lesional injections at a single cystoscopy, Global Response Assessment, no adverse events",
      "2005 ulcerative-colitis enema abstract via the FDA reconstruction; interval includes no difference; printed point estimate inconsistent with its interval, which the review flags",
      "36588717 IV elimination half-life under 30 minutes; IM bioavailability ~14-19% rats, 45-51% dogs; species difference stated",
      "42542926 independent rat tendon test called inconclusive at four tendons per group, not a failed replication",
      "21030672 in vitro outgrowth, survival under H2O2, migration, F-actin, FAK-paxillin; proliferation not directly increased",
      "33376304 clopidogrel co-administration model, 10 rats per group, L-NAME attenuation; protection not faster healing",
      "15052688 intramuscular and intragastric dosing, acute and chronic ulcer models, glandular epithelium rebuilding",
      "20225319 rat medial collateral ligament, no independent replication",
      "40756949 systematic review: 36 studies, 35 preclinical, 1 clinical",
      "42578445 'remain unsubstantiated by current human trials'; its cardiovascular and metabolic risks belong to other peptides and are not attributed to BPC-157"
    ]
  },
  "residual_limitations": "Three human reports and several rat studies were abstract-depth only, so Methods and Results figures (the Bicer medians and p values, the knee review's instrument statement, the FDA reconstruction of the 2005 enema abstract) were confirmable here only against the review's own receipts and the FDA briefing document. The 2005 ulcerative-colitis trial remains a meeting abstract known through an administrative synthesis. Human pharmacokinetics remains unresolved rather than negative.",
  "propagation_strings_for_lead": [
    {
      "file_class": "any package-level file reproducing the provenance clause",
      "old": "The earlier adversarial approval refers to its original edition; this provenance supplement is not a new independent or blinded adjudication.",
      "new": "No earlier adversarial approval is attached to this case; the 2026-10-06 adversarial pass did not cover it, and this provenance supplement is not a new independent or blinded adjudication."
    },
    {
      "file_class": "any package-level file reproducing the claim-register repair note",
      "old": "The original approval predates this repair.",
      "new": "No earlier adversarial approval is attached to this case."
    }
  ],
  "approval": "Approved as revised. — Claude Opus 5.5 (Anthropic), 2026-10-14."
}