{
  "completed": true,
  "status": "completed_original_source_reconciliation",
  "provider_mode": "Consensus Pro signed-in browser; observed output and citation link mappings",
  "queries": [
    "https://consensus.app/search/microplastic-exposure-cardiovascular-risk/DfgH6yoiShaPFdLu_vlgfA/"
  ],
  "query_record_note": "Exact provider question/response retained privately in its retrieval receipt.",
  "primary_comparison_count": 8,
  "primary_comparisons": [
    {
      "pmid": "38446676",
      "doi": "10.1056/NEJMoa2309822",
      "source_type": "primary study report",
      "study_group": "MARFELLA-CAROTID-2019-2020",
      "access_depth": "full_text_partial",
      "consensus_aspect": "Prospective cohort design, attrition and actual endpoint",
      "result_comparison": "Consensus describes 304 carotid-surgery participants and 257 completing follow-up. The examined original body records 312 screened, eight perioperative stroke/death exclusions and 47 with incomplete data or lost follow-up, leaving 257. Its primary endpoint includes nonfatal infarction, nonfatal stroke or ALL-CAUSE death, not cardiovascular death alone. Events were adjudicated without knowledge of polymer results, but exposure groups were observational and visits were unscheduled.",
      "original_source": "https://pubmed.ncbi.nlm.nih.gov/38446676/",
      "source_examination_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\examinations\\original-0-8-2200.json"
      ],
      "body_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\38446676-s0-p0-1-2-3-5.json",
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\38446676-s1-p0-1-2-5-6.json",
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\38446676-s2-p3-4.json"
      ]
    },
    {
      "pmid": "38446676",
      "doi": "10.1056/NEJMoa2309822",
      "source_type": "primary study report",
      "study_group": "MARFELLA-CAROTID-2019-2020",
      "access_depth": "full_text_partial",
      "consensus_aspect": "Adjusted association is not causal risk or independent cohorts",
      "result_comparison": "The provider reproduces adjusted HR 4.53 and acknowledges absent causality. Selected original Results confirm 30/150 versus 8/107 events and an adjusted HR 4.53; Methods and Discussion retain residual socioeconomic, air-pollution and dietary confounding and possible contamination. The provider coverage grid lists seven longitudinal carotid MACE papers, but cited reviews or repeated citations do not create seven primary independent cohorts. We retain one parent study unit and do not use its meter or coverage counts as causal probabilities.",
      "original_source": "https://pubmed.ncbi.nlm.nih.gov/38446676/",
      "source_examination_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\examinations\\original-0-8-2200.json"
      ],
      "body_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\38446676-s0-p0-1-2-3-5.json",
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\38446676-s1-p0-1-2-5-6.json",
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\38446676-s2-p3-4.json"
      ]
    },
    {
      "pmid": "40007360",
      "doi": "10.1016/j.jhazmat.2025.137624",
      "source_type": "primary study report",
      "study_group": "PMID40007360",
      "access_depth": "abstract_metadata",
      "consensus_aspect": "Post-MI odds and uncertain risk-conversion wording",
      "result_comparison": "Consensus reports 110 patients with 31.5-month follow-up and OR 1.090 for PVC/event association. The original abstract confirms these observations in a 142-enrolled prospective observational cohort plus a separate 21-patient thrombus series. The listed OR 2.374 and accompanying 1.374-fold-increase wording require interpretation not resolved by our abstract access; no uncertain numerical risk conversion is reproduced. These odds associations do not establish particle-caused clinical events.",
      "original_source": "https://pubmed.ncbi.nlm.nih.gov/40007360/",
      "source_examination_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\examinations\\original-16-24-1800.json",
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\examinations\\original-18-19-10000.json"
      ],
      "body_receipts": []
    },
    {
      "pmid": "35394514",
      "doi": "10.1001/jamanetworkopen.2022.6257",
      "source_type": "primary study report",
      "study_group": "ACTRN12619000204145",
      "access_depth": "full_text_partial",
      "consensus_aspect": "Donation removes measured serum chemicals, with contrast-specific results",
      "result_comparison": "The provider gives 285 firefighters, 52 weeks and plasma-related PFOS/PFHxS reduction. Selected original Methods/Results independently confirm randomization, donor eligibility and chemical serum endpoints. Blood PFHxS change is nonsignificant within group but significantly lower than observation between groups because the control trajectory differs. Neither contrast is evidence of human plastic-particle clearance; the trial did not measure a particle-removal endpoint.",
      "original_source": "https://pubmed.ncbi.nlm.nih.gov/35394514/",
      "source_examination_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\examinations\\original-51-59-10000.json"
      ],
      "body_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\35394514-s1-p0-1-3-5-6-7.json",
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\35394514-s2-p0-1-2-3-4-5-6.json",
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\35394514-s2-p7-8-9-11-13-14-15.json"
      ]
    },
    {
      "pmid": "35394514",
      "doi": "10.1001/jamanetworkopen.2022.6257",
      "source_type": "primary study report",
      "study_group": "ACTRN12619000204145",
      "access_depth": "full_text_partial",
      "consensus_aspect": "Burden reduction and clinical health are distinct endpoints",
      "result_comparison": "Consensus correctly says no cardiovascular-event reduction was demonstrated. The original trial was powered for concentration changes; selected Results find no significant between-group improvement in lipid, thyroid, liver or kidney panels, lower hemoglobin after blood donation and more adverse events with plasma donation. The provider categorical statement that these procedures do not extract solid particles goes beyond the tested endpoint. We use the bounded conclusion that these trials do not establish particle clearance or clinical-event benefit.",
      "original_source": "https://pubmed.ncbi.nlm.nih.gov/35394514/",
      "source_examination_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\examinations\\original-51-59-10000.json"
      ],
      "body_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\35394514-s1-p0-1-3-5-6-7.json",
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\35394514-s2-p0-1-2-3-4-5-6.json",
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\body-presentation-receipts\\35394514-s2-p7-8-9-11-13-14-15.json"
      ]
    },
    {
      "pmid": "40974835",
      "doi": "10.1016/j.envint.2025.109794",
      "source_type": "primary study report",
      "study_group": "PMID40974835",
      "access_depth": "abstract_metadata",
      "consensus_aspect": "Ronneby crossover chemical elimination versus detox efficacy",
      "result_comparison": "Consensus reports ten exposed participants and a 38% mean PFOS decline during 12-week colesevelam. The examined original abstract confirms chemical-specific serum/fecal/urinary measurements, cholestyramine-enhanced fecal PFOS and a small control-period decline. It calls for evaluation of risks, costs and benefits. This is chemical elimination evidence, not a measured plastic-particle endpoint or demonstrated cardiovascular health improvement.",
      "original_source": "https://pubmed.ncbi.nlm.nih.gov/40974835/",
      "source_examination_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\examinations\\original-51-59-10000.json"
      ],
      "body_receipts": []
    },
    {
      "pmid": "37669592",
      "doi": "10.1016/j.envint.2023.108171",
      "source_type": "primary study report",
      "study_group": "PMID37669592",
      "access_depth": "abstract_metadata",
      "consensus_aspect": "Organoid concentration is not calibrated ordinary human dose",
      "result_comparison": "The provider presents low-concentration cardiac-organoid findings as mechanistic support while warning about translation. The original report appraised by the coordinator uses administered polystyrene in mouse/organoid systems with injury/hypertrophy measures. An asserted low internal concentration is not a validated human pharmacokinetic bridge; organoid markers and wall thickness do not supply a prospective human major-event estimate.",
      "original_source": "https://pubmed.ncbi.nlm.nih.gov/37669592/",
      "source_examination_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\examinations\\original-8-16-2000.json"
      ],
      "body_receipts": []
    },
    {
      "pmid": "35367073",
      "doi": "10.1016/j.envint.2022.107199",
      "source_type": "primary study report",
      "study_group": "PMID35367073",
      "access_depth": "abstract_metadata",
      "consensus_aspect": "Analytical detection does not establish clinical causation",
      "result_comparison": "The provider distinguishes detection from harm. The examined original blood-method abstract quantifies several polymers in 22 healthy volunteers, with polypropylene below quantification. Chemical mass measurements above thresholds support internal exposure; they do not identify a clinical toxicity threshold, particle-resolved dose or cardiovascular-event dependency.",
      "original_source": "https://pubmed.ncbi.nlm.nih.gov/35367073/",
      "source_examination_receipts": [
        "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\examinations\\original-33-42-10000.json"
      ],
      "body_receipts": []
    }
  ],
  "grade_changed": false,
  "grade_change_note": "Source-based adjudication; no independent blinded regrade claimed.",
  "raw_receipts": [
    {
      "path": "deliverables\\hsef_v53_traffic_ranks_06_10_2026-10-13\\microplastics-cardiovascular\\consensus-browser-2026-10-13.json",
      "sha256": "40647334bddf99614d7502e1b5e7dde69ff39132aab4f0fd7fc22be9778affe3"
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  ],
  "independent_blinded_audit": false,
  "cutoff": "2026-10-13",
  "completed_utc": "2026-10-13T16:38:32.150288+00:00",
  "conclusion": "Endpoint hierarchy, experimental scope and original-source limits determine the evidence cards; provider wording does not override them."
}