### Consensus consistency validation — 9 October 2026

Cutoff: 2026-10-09. Provider artifacts: `consensus-browser-response.md` (verbatim, citation markers preserved), `browser-thread.json`, `consensus-search-raw.json`. Consensus thread: [Vitamin D causality and chronic diseases](https://consensus.app/search/vitamin-d-causality-chronic-diseases/sqNKF21DQ-asym5mmARvjQ/), Pro. The response is a useful discovery map, but most bibliography entries are reviews, guidelines, or meta-analyses; their summaries are not treated as primary verification. The hypothesized exposure is deficiency, whereas most large RCTs test supplementation in broad populations with modest baseline deficiency; these are not interchangeable estimands.

#### Primary-source reconciliation

- **PMID 30415629; DOI 10.1056/NEJMoa1809944 (VITAL primary RCT).** 25,871 generally healthy older adults randomized to 2,000 IU/day vitamin D3 or placebo; over 5.3 years no significant reduction in invasive cancer (HR 0.96, 95% CI 0.88–1.06), major CVD (HR 0.97, 0.85–1.12), or all-cause mortality (HR 0.99, 0.87–1.12); cancer-mortality signal was uncertain. Original package evidence source 1, full-text-partial, study key VITAL; already counted.
- **PMID 37380191; DOI 10.1136/bmj-2023-075230 (D-Health primary RCT secondary endpoint analysis).** 21,315 adults aged 60–84 randomized to 60,000 IU/month or placebo for up to 5 years. Composite major CV event HR 0.91 (0.81–1.01), absolute difference CI spans zero; MI HR 0.81 (0.67–0.98), stroke null. Subgroup interaction among those using CV drugs was not significant. Original evidence ledger source 6 in `selected-records.json`, `evidence.json`, canonical review, and appraisals.tsv; study key `D_HEALTH`. It was already counted. The endpoint paper belongs to the same D_HEALTH randomized cohort and is not an independent trial.
- **PMID 35026158; DOI 10.1016/S2213-8587(21)00345-4 (D-Health primary mortality report).** Original ledger source 12, study key D_HEALTH, already counted. RCT population-level mortality outcome showed no clear mortality reduction; it shares randomization/cohort with the above D-Health reports and must not be counted as an independent trial.
- **PMID 40096917; DOI 10.1016/j.jsbmb.2025.106738 (D-Health cancer-incidence report).** Original ledger source 10, study key D_HEALTH, already counted; this is another outcome report from the same randomized cohort, not a new RCT. It informs the null/qualified pattern but does not independently multiply evidence.

#### Claim/score judgement

The review’s core distinction remains sound: observational deficiency associations do not by themselves demonstrate supplementation causality, and the large trials are not direct tests of treating frank deficiency. Broad disease-prevention claim overall remains **Γ / Moderate**; no score change. VITAL’s population and endpoints, D-Health’s modest/uncertain composite and subgroup interaction, and shared trial groups preserve the same scope limits. No new independent primary trial was established by the Consensus bibliography; its reviews do not add causal units. Original totals remain **50 reports, 54 verified claims**. The trial protocol and additional endpoint publications are not new independent trial units. No grade/scorecard patch proposed.

This is a source-anchor reconciliation, not an independent blinded review. Consensus summaries/tags were not treated as primary findings or tiers.

#### Primary record links

[PMID 30415629](https://pubmed.ncbi.nlm.nih.gov/30415629/) · [PMID 37380191](https://pubmed.ncbi.nlm.nih.gov/37380191/) · [PMID 35026158](https://pubmed.ncbi.nlm.nih.gov/35026158/) · [PMID 40096917](https://pubmed.ncbi.nlm.nih.gov/40096917/)


This dated supplement adds source reconciliation to the original review. Its original narrative, registered scope, source inventory and grades remain historical records. No earlier adversarial approval has been verified for this edition at the supplement date. This provenance supplement has no separate approval and is not an independent or blinded adjudication. New sources described here are supplemental and are not counted in the original inventory.