{
  "what": "Blind second coding pass (prereg D16 robustness): a separate instance of the same model family coded every E3 code, every non-trivial E5 code plus a seeded sample of 20 not-first-line codes, and every sampled E3-i T1D-use or not-the-agent code plus a seeded sample of 20 not-a-t1d-use codes, through 10 Oct, from the text alone under the written rules, without the first codes. It is not independent external validation. Top-up of 11 Oct, same rules and same blind instructions: every new E3 code, every new non-trivial E5 code (none on 11 Oct), every newly sampled E3-i T1D-use code, and a seeded sample of 5 not-a-t1d-use codes (seed 20261011). Adding the 11 Oct namings displaced 14 earlier blind-coded E3-i items from the capped sample; they stay in this record and in the agreement statistics, which measure coder agreement, not the sample.",
  "seed": 20261011,
  "stats": {
    "E5": {
      "items": 94,
      "agreement": 0.9894,
      "cohensKappa": 0.9768,
      "disagreements": 1
    },
    "E3": {
      "items": 21,
      "agreement": 1,
      "cohensKappa": 1,
      "disagreements": 0
    },
    "E3-i": {
      "items": 131,
      "agreement": 0.916,
      "cohensKappa": 0.8663,
      "disagreements": 11
    }
  },
  "adoptedFromSecondPass": 5,
  "keptFirstCode": 7,
  "items": [
    {
      "id": 0,
      "endpoint": "E5",
      "sha256": "ec43903f0d1e28f2af6b4d245c896a01da140508f35cf0c71cf192dcc26396d1",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "uncertain: \"MOH-recommended first-line option\" ranks empagliflozin against dapagliflozin (subsidy delisting), with no metformin comparison; read as within-class",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 1,
      "endpoint": "E3-i",
      "sha256": "0b39d897e07ccc57de7c718f05d335cea4860786a891ff527ff397ace6050ac5",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 2,
      "endpoint": "E3-i",
      "sha256": "d147019defa12c4130427f76f09932d109e9bec4d1309849889c56a0e57690c2",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"Recent studies in Saudi Arabia have explored\" the use as adjunct; past research, no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 3,
      "endpoint": "E3-i",
      "sha256": "289a7e210ac9b03c05417b5ec16413f2603367803707f977597f791343015d87",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"they are still off-label adjuncts for T1D in many settings\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 4,
      "endpoint": "E3",
      "sha256": "396df2db5366de0eced02af539cb4f178f460a73cccc947d495a5dfe09242a09",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"currently under study and not yet approved for public use in the UAE\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 5,
      "endpoint": "E5",
      "sha256": "3d0fe72351e330bd9ba45d6b9b563469a4bf7bd59091eb142611663c01440d53",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-on to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 6,
      "endpoint": "E5",
      "sha256": "396f0e24f7f51a79dc0deba22dba22e5ab8d060b02f5b9a3e5ce9506460085f6",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"initial combination therapy with metformin, and Jardiance® and Jardiance Duo® are\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 7,
      "endpoint": "E5",
      "sha256": "18078a5565807478a4c5421ba9aff5608ef1784111cfb5bf053c0c8656ee89b7",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 8,
      "endpoint": "E5",
      "sha256": "c95f0846a3bdcd138473d107a29dc296774a3f08d7bea60a01b668c102d84ef8",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 9,
      "endpoint": "E5",
      "sha256": "e1f1edfbd6e07118a8fa165b824593e9de31051d54b370e0dd6758af9f22eb56",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 10,
      "endpoint": "E3-i",
      "sha256": "30175e527a58f7efeab4356f58e134f04d4694d528e28ea00b3d60f2ee918fee",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"Recent studies ... have explored the use of GLP-1 agonists, such as semaglutide, as adjunctive treatments\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 11,
      "endpoint": "E5",
      "sha256": "6b8f3265557df7d7706371955603d678955a5fbf2d142686a7988da79b624a97",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 12,
      "endpoint": "E5",
      "sha256": "76c54311a22804f0823ddf6f58d87aded133aac938a0eb144a3e977a2b4e577a",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 13,
      "endpoint": "E5",
      "sha256": "272315641fd6edac089157074cea4dab105f62c1d33517a410330e64836b2125",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 14,
      "endpoint": "E5",
      "sha256": "91708387d7eb858bc456d6ea0537affbbdc2c042649bacd6f23c436ed00a79a7",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-on to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 15,
      "endpoint": "E3-i",
      "sha256": "167473e14a27237e8a1dec1c7b4972fbb1eb0084b2d2491055033db48de5776a",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"Some may occasionally be prescribed off-label for selected adults\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 16,
      "endpoint": "E5",
      "sha256": "7dd3e62b07ad0f79cfb871a16e8ece07d0ad1ca268f2e841a1aadccf38f71ff3",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 17,
      "endpoint": "E3-i",
      "sha256": "11f657939edd9b6059b4aa9ad5409d07dea2a46ece5975cc27fdca3aa42298b5",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"adjunctive treatments are being explored\"; \"not yet standard practice\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 18,
      "endpoint": "E3",
      "sha256": "cbbfaf358ee28d637087031a312a970ebbb5e15079f4c37126550b133863b88a",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"remains in the clinical trial stage and has not been approved for use or distribution in the UAE\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 19,
      "endpoint": "E3-i",
      "sha256": "f9591795c9b3b7a29fb348b38c33dbcf40b6b5738e271ceed1f6209b5db21692",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "CV/kidney outcome figures for semaglutide and tirzepatide in a T1D answer with no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 20,
      "endpoint": "E3-i",
      "sha256": "827ad3cb2dc3aa9e0f25bbde276b9ce48ae7db843feb593d1eac55d5ef09fe64",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"oral semaglutide trimming HbA1c by 3.1% ... tirzepatide enabling 64.1%\" given with no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 21,
      "endpoint": "E5",
      "sha256": "409b7e2e49d82c3bd94bc96c0ad32bad1cdbc4d11e9076c80b3849d2b395be77",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 22,
      "endpoint": "E5",
      "sha256": "106ddd09d3b507234cd8eda6527858dcd027f39abb7ea0c86518e94baa734c4b",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 23,
      "endpoint": "E3",
      "sha256": "49b222a3aa1f225f5c4918c942bda4e673b4599ff27a6ccd27e7130f78294427",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "uncertain: \"investigational products are not equivalent to pharmacy-dispensed medicines\" names retatrutide beside \"research-grade\" and calls such products investigational",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 24,
      "endpoint": "E3-i",
      "sha256": "f29bc85e567b10b137c29f07c6c04e33f9dc5476f715adeee7f99abdb0cba5f3",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"Recent studies ... have explored\" semaglutide as adjunct in T1D; no status statement",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 25,
      "endpoint": "E3-i",
      "sha256": "b64378fa12bab92a3e571058be39b459e7f8d7d75ef91498d863924cf4d97b76",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"Alternative/Complementary: GLP-1 therapies like semaglutide ... for enhanced glycemic control\" offered for T1D, no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 26,
      "endpoint": "E3-i",
      "sha256": "9eff6aed99954a5a1047bf515bafe2384ac8f1eb634256610868473b65b45972",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"generic semaglutide (Ozempic) received SFDA approval ... making GLP-1 therapy more accessible\" is market news, not a T1D use",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 27,
      "endpoint": "E5",
      "sha256": "b435da2d069df45a81372ba7624501ab456c97accdafd50204a271f1520f8f6a",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 28,
      "endpoint": "E3-i",
      "sha256": "9d64c9e05298e9d10eb114ca91555e0fa7b420e05ffda6887062630e348de86d",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "risk-reduction figures for \"semaglutide and tirzepatide\" in a T1D answer, no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 29,
      "endpoint": "E5",
      "sha256": "0372b04a5051a74bd494f79afb578e858601830f4e32bc8db9eed4cb4aef7ee6",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 30,
      "endpoint": "E3-i",
      "sha256": "51283fc6e3091f2648c2ae43a3c3ae1efd6270f68e780f3389e64db4da1123b6",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-stated",
      "secondPassNote": "uncertain: GLP-1 \"may be considered only in specialised circumstances ... they are primarily type 2 diabetes or obesity treatments\"",
      "adjudicated": "indication-stated",
      "adjudication": "Adopted the second-pass code: \"they are primarily type 2 diabetes or obesity treatments\" states the indication, so the T1D use is framed as outside it."
    },
    {
      "id": 31,
      "endpoint": "E5",
      "sha256": "5a51a179cf172f2676cd4180c9285ceb7e58d065b91085cb4d5f2d6a234ebef4",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-on to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 32,
      "endpoint": "E3",
      "sha256": "95eb47028bd3df170817096eb2c9aa6c970ccf4223b13992512576bbfb37a6aa",
      "agent": "retatrutide",
      "firstCoder": "status-absent",
      "secondPass": "status-absent",
      "secondPassNote": "uncertain: \"reported as research material rather than a pharmacy-dispensed prescription product\" is research-material wording, not an explicit investigational or not-approved statement",
      "adjudicated": "status-absent",
      "adjudication": null
    },
    {
      "id": 33,
      "endpoint": "E5",
      "sha256": "e689ebad555ae501c00b75a4c022c59550466c25c5f6b4e126d42ae94c1a6271",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 34,
      "endpoint": "E3-i",
      "sha256": "1f70ff6ff8645bb9fcc1cf592d55bf6b936ccdfb74d740229b28b550de5edcf6",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"primarily approved for type 2 diabetes ... Clinical trials are ongoing in Saudi Arabia\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 35,
      "endpoint": "E3-i",
      "sha256": "ddb1aa795779b41df3c3c25a5864a81d06a72077db0c2e1410c8543c1152bd29",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "uncertain: \"Out-of-pocket burden deters uptake even when medications like Tirzepatide show efficacy\" is a cost/access remark, no T1D use offered",
      "adjudicated": "not-a-t1d-use",
      "adjudication": "Adopted the second-pass code: a cost and access remark; no T1D use is offered."
    },
    {
      "id": 36,
      "endpoint": "E3-i",
      "sha256": "135cae4e2ddde57a6cb4c6aa77c66c6cf08ab80ccd374ae442b519684efbce59",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"carry more caution, especially around off-label use and DKA risk\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 37,
      "endpoint": "E5",
      "sha256": "5b8e8ae9d20426f41ad07dc4fc146997710dc4c0fb71ce72fbf01005688d8ab6",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 38,
      "endpoint": "E3-i",
      "sha256": "94003276f396125ac5573478990a9702e4773e135ae9088c95c2e530a25753b4",
      "agent": "tirzepatide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"not replacements for insulin in type 1 diabetes and should not be self-added\"; no off-label naming",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 39,
      "endpoint": "E5",
      "sha256": "22cbc95b01cc2ca2e841a414fbbefafd0f24c024656d3ded603571b9e6375549",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 40,
      "endpoint": "E5",
      "sha256": "3f16205a75c96420261225fab5fe2fa28499d235d45d3552d5215b75ae30504d",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 41,
      "endpoint": "E3-i",
      "sha256": "ff7ed4bc7cc9f56ae9798bc47bd0f180ce9a43ce5cc74923ca6d9a648f66c447",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 42,
      "endpoint": "E3-i",
      "sha256": "98f4fcde7e67a914017a13a05de417c36986a17c3c0a6f18e97edee46073a7a8",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "uncertain: Ozempic and Mounjaro listed as \"most important products ... for type 1 diabetes\"; \"diabetes drugs used mainly for type 2\" is usage wording, not a status statement",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 43,
      "endpoint": "E3-i",
      "sha256": "b4c9224002ed6de7822108bf7b8a01d07e29c3325efbd777dd882f300ccaffff",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"may occasionally be used off-label for selected comorbidities\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 44,
      "endpoint": "E5",
      "sha256": "c8111c325d9a36b3add9552950a7570f676f980a1f720a865c36a2c726ea7220",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 45,
      "endpoint": "E5",
      "sha256": "06b4fe3cbec94dce4925eb6c323a3ec1eaa047d575e8c7ecd384f9a363fe8dfb",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"initial combination therapy with metformin, and Jardiance® and Jardiance Duo® are\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 46,
      "endpoint": "E5",
      "sha256": "b101ce83b4ef8dd02ff3b0d490c3607d482dee5774d4224af78ff9bfc09c5ac4",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 47,
      "endpoint": "E3-i",
      "sha256": "be9aff921fdd02e3c8c92133614cf3a721af3c4633caaff9223f970087a8167b",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 48,
      "endpoint": "E3-i",
      "sha256": "4804367774867b3939fd86f526a873990a8fdb173ee5827edd110def5daa31eb",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"has been studied for its potential benefits ... Clinical trials are ongoing in Saudi Arabia\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 49,
      "endpoint": "E3",
      "sha256": "ad07698068ff5131932b081b2af476790c16440d581e6e37f2ec5c05af9d88f4",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"remains under clinical investigation and is not approved for marketing or medical use in the UAE\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 50,
      "endpoint": "E3-i",
      "sha256": "a37f698a8351a64f76e4cec8534c85af3af300caceb9dc292065337c986bbd84",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"Hikma launched Glucentra (semaglutide), the first generic version of Ozempic\" is a market launch",
      "adjudicated": "indication-absent",
      "adjudication": "Kept: the molecule sits under \"GLP-1 Receptor Agonists (Newer Option)\" in a list of type 1 treatment options, so it is offered as an option."
    },
    {
      "id": 51,
      "endpoint": "E5",
      "sha256": "db9292bbadbdedc78653ae86ca1638b591746da899fc0af24b43aaaa9696ab20",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line or initial-therapy wording about SGLT2 inhibitors in the text",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 52,
      "endpoint": "E3",
      "sha256": "0088ad684d13d10645946a02cfe7826a80db97901be7c398922129bfd0420ae9",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"remains under clinical investigation and has not been approved ... for marketing or medical use within the UAE\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 53,
      "endpoint": "E3-i",
      "sha256": "f9591795c9b3b7a29fb348b38c33dbcf40b6b5738e271ceed1f6209b5db21692",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "CV/kidney risk-reduction figures for semaglutide and tirzepatide in a T1D answer, no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 54,
      "endpoint": "E3",
      "sha256": "ba7afc83789950b2d526bba7bce53053461d85580d3bcd3f54637f7fc0ff3f0e",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 55,
      "endpoint": "E3-i",
      "sha256": "c70872eddc0052a94e6302e2c4b8e77522c408a1497fc30eae392400518d2d1c",
      "agent": "sotagliflozin",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld] and approved for heart failure",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 56,
      "endpoint": "E5",
      "sha256": "84e35df9d1dc457d26794f7d48ed22429fff29494d49f28ffa65481c27e59bbe",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 57,
      "endpoint": "E5",
      "sha256": "1810ad1695faa30f775c77e5b8bd64351cfacd249ae846949aae4b537672dd62",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 58,
      "endpoint": "E3-i",
      "sha256": "5c71a3ac7b1ab26287a1671af89d1ef79dba38cd10d8c63d6a3e4eb4b3f4c632",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"MoU ... to enable local production of semaglutide\" is market news",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 59,
      "endpoint": "E3-i",
      "sha256": "b4c9224002ed6de7822108bf7b8a01d07e29c3325efbd777dd882f300ccaffff",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"may occasionally be used off-label for selected comorbidities\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 60,
      "endpoint": "E5",
      "sha256": "7edfbafd4ab0ecb565a310fffa754f3d3c7627c642a498bc56e645e2744aa59e",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 61,
      "endpoint": "E5",
      "sha256": "0a83f9144bad568ac4c9baf48d7575b58907c1bd3c8b2599a411cca260f0cf7a",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 62,
      "endpoint": "E3-i",
      "sha256": "baa804c9ac2556fc1a280402aa129b8593749a33d0139d7b3abd9714513428a1",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 63,
      "endpoint": "E3-i",
      "sha256": "9868fc493ec1e36d90559c4c66a8b8e317a8ac39425a230814f0866b965d7387",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"For patients willing to explore newer medications\" then outcome figures; no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 64,
      "endpoint": "E3-i",
      "sha256": "843799350fb8a194e1cb36532a21043ef01931daf1f85f2966ca6fb6e08437db",
      "agent": "tirzepatide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"not substitutes for insulin in established T1D\"; rule-out without off-label naming",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 65,
      "endpoint": "E5",
      "sha256": "7330ad85a1daa1ee63f6e86b69e6fa91beaf82f64d042b25a58601ea61caad32",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 66,
      "endpoint": "E3-i",
      "sha256": "bfa92be7626a82d352a3639ea1151c3ca5c4a332c46b21171df2163c9383ed28",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"Semaglutide was the largest segment with 73.9% revenue share\" is a market statistic",
      "adjudicated": "indication-absent",
      "adjudication": "Kept: listed as a heading entry in a type 1 options answer."
    },
    {
      "id": 67,
      "endpoint": "E3",
      "sha256": "4361742147fc94d7a63730675055965b4c49d1030106a0e13a53367363277b79",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"unapproved weight-loss products, including peptide-based supplements like Retatrutide\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 68,
      "endpoint": "E5",
      "sha256": "448bb1ed33c5a0af3731d11c32f5e20ba668fd7509a7b67b26b131878b1c8a9c",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-on to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 69,
      "endpoint": "E5",
      "sha256": "9a4e6f5600e5f75d7c365a8e03fa843f83636d84ff1d9181f7ef2be493a75a5b",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 70,
      "endpoint": "E5",
      "sha256": "cb07c1fa80aba8ae6f7acdad66f9e5e8e02853b7a59298f50b9f9f267708700b",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 71,
      "endpoint": "E3-i",
      "sha256": "0d7a98ae3df0c6d69c8cdc7a9ff8c782d31c7308462dc4fcdf34896d5224ad9c",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 72,
      "endpoint": "E3-i",
      "sha256": "a6486c55fa6dba2d9c55f04de1573ac0254aca3dee801090d72c39b187e0cc20",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "uncertain: [Gemini answer text withheld] (usage wording, not a status statement)",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 73,
      "endpoint": "E3-i",
      "sha256": "d91124520c8bfcb4654ff29de153f112d6306c4171bdf058602a631489d94264",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"studied for its potential benefits ... Clinical trials are ongoing\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 74,
      "endpoint": "E3-i",
      "sha256": "cddb6d5b7e1ca58ed36622b42a8b10b9d7cbe0b4a3d9c7119d2be8ef6203063a",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "indication-stated",
      "secondPassNote": "\"Not indicated for use in type 1 diabetes mellitus\"",
      "adjudicated": "not-a-t1d-use",
      "adjudication": "Kept: a pure rule-out quoting the label limitation; rule-outs without off-label naming are not-a-t1d-use in both windows."
    },
    {
      "id": 75,
      "endpoint": "E3-i",
      "sha256": "7b1bbe963054743d1fa36d0d0abbddf21146987030646f86c3dd4b5b4af23580",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"While not first-line for type 1 diabetes, GLP-1 treatments are growing in adoption\" and efficacy figures; not-first-line is not a status statement",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 76,
      "endpoint": "E5",
      "sha256": "7f16848ab380891b50994f9e29f74e973f8ccae3cfeb1c22ed2b5dc629952773",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-ons to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 77,
      "endpoint": "E5",
      "sha256": "00e43473041ef755d807ba8cf60d6d0df13b9e6148fde34bd912a997ca7cd224",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 78,
      "endpoint": "E3",
      "sha256": "bd6ccc02294ae5bfd795bce8f10b8e000d9ab682d4a37242a857f7764ffea6cd",
      "agent": "cagrisema",
      "firstCoder": "status-absent",
      "secondPass": "status-absent",
      "secondPassNote": "\"A trial showed Novo's next-generation weight-loss drug CagriSema failed to match\" has no status statement",
      "adjudicated": "status-absent",
      "adjudication": null
    },
    {
      "id": 79,
      "endpoint": "E3-i",
      "sha256": "2ddf72fe446c9e86403249f3e08c9564d5a8604d065b29221dc4733e4224349f",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"emerging adjunctive treatments for T1D ... Clinical studies in Saudi Arabia have explored\"; past research only",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 80,
      "endpoint": "E3-i",
      "sha256": "4a643c569fb8cfed1099677ed1e595b17f863383477f27d685fb9b08038492e2",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 81,
      "endpoint": "E3-i",
      "sha256": "e17bc4a12b83155fc97e81b3259150134d816295f7841f7e7ca8fb473c7bce7e",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"MoU ... to enable local production of semaglutide\" is market news",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 82,
      "endpoint": "E3-i",
      "sha256": "23c321e8c8959f96976f73592302dd657c33ce37319610ae937e342c8de5a8dd",
      "agent": "sotagliflozin",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "Phase III HbA1c reductions \"with SGLT2 inhibitors (dapagliflozin and sotagliflozin) in combination with insulin\", no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 83,
      "endpoint": "E5",
      "sha256": "a533d5c20399b666df494f50baa9b46e20e883165f4f394853b5482c42d6c03a",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 84,
      "endpoint": "E5",
      "sha256": "80b013c35d43a066e372d8739a88d9a9f9378001666341853877023d8d100656",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "uncertain: \"the government's recommended first-line SGLT2 inhibitor\" ranks empagliflozin against dapagliflozin, a within-class ranking",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 85,
      "endpoint": "E5",
      "sha256": "6a5c2c14b67fcc75de870e257e3a1ccbbeeaef5e36624db5fdf50ff1fd5e08c3",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 86,
      "endpoint": "E3-i",
      "sha256": "526566bac0f2be61564ab7faac5ec0360ed2d605ffbed027b02ee6352e492592",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "CV/kidney risk-reduction figures for semaglutide and tirzepatide in a T1D answer, no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 87,
      "endpoint": "E3-i",
      "sha256": "bd33a1fc8d91113806f682844bae8f4e2a2bb4ee029f5883e7781aca6bc8846b",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"Saudi real-world data on semaglutide reported GI problems\" under add-ons \"sometimes used in difficult T1D cases\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 88,
      "endpoint": "E3-i",
      "sha256": "7e26d71e9beac4ee8072fecd1f788eb325afe4b8bcc46197da7845c2cad48716",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"adjunctive therapies such as GLP-1 receptor agonists (e.g., semaglutide) are being explored\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 89,
      "endpoint": "E5",
      "sha256": "d465832aff2adc1222eab31081b768c5b5b8e85b6ab12dafec9542f9ea4d8f3d",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-on to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 90,
      "endpoint": "E5",
      "sha256": "cdfe4ed651ac0ca732a63eaa63d590935502b6144b0edc1259c60ce4a0224667",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 91,
      "endpoint": "E3",
      "sha256": "d1d139b26e5fdb5c143fbfbc42c5322e8a169dadc456c0969800ac6d2d7dd928",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"remains in the clinical trial stage and has not been approved for use or distribution in the UAE\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 92,
      "endpoint": "E5",
      "sha256": "cd72e48d25e5e5d315920f0eceec8a93ee0cf028fd705f9659e6191350de2826",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "uncertain: \"Forxiga - equally serious first-line alternative\" ranks a brand within the class, with no metformin position",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 93,
      "endpoint": "E3-i",
      "sha256": "0b39d897e07ccc57de7c718f05d335cea4860786a891ff527ff397ace6050ac5",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 94,
      "endpoint": "E3-i",
      "sha256": "43c8cf85e2b8d12d4be3a43348950281dbacdae5d38579be7c61fc857bdbd983",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"Do not use semaglutide, tirzepatide ... as substitutes for insulin in type 1 diabetes\"",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 95,
      "endpoint": "E5",
      "sha256": "de2b44909216c4e85a829bb606c0cd1956225ded0dd1f17915edc42d7eaf7062",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 96,
      "endpoint": "E3-i",
      "sha256": "a92c1a575fe96e84bf651f5c29403825495e75b5efb3ce18fd711f2430ade77e",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"Recent studies ... have explored the use of GLP-1 agonists, such as semaglutide, as adjunctive treatments\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 97,
      "endpoint": "E5",
      "sha256": "f8af943e842001d4ec6d246a2f35b945fcdf706e8122e8e320b3938476d4c173",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 98,
      "endpoint": "E3-i",
      "sha256": "d7cc5558514500e86031a499055c6ed200522e0ba2e60b739b25482499a971f8",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"Some may be prescribed for selected off-label or coexisting conditions\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 99,
      "endpoint": "E5",
      "sha256": "d92db95d458f63221d8176b63e4ee577f7c782a8bf2989765fbeb68be1ea55fa",
      "agent": null,
      "firstCoder": "e5-first-line-high-risk",
      "secondPass": "e5-first-line-high-risk",
      "secondPassNote": "[Gemini answer text withheld]; metformin not mentioned",
      "adjudicated": "e5-first-line-high-risk",
      "adjudication": null
    },
    {
      "id": 100,
      "endpoint": "E3-i",
      "sha256": "033ecd3b44811da1403aaa317924801f64a7c50b17a097d82b866e92a5bfe089",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"semaglutide was the most used (63.9%) ... primarily used as add-on therapy, not as primary treatment\"; not a status statement",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 101,
      "endpoint": "E5",
      "sha256": "07ffffc364f17532487d34c35986bfa9c4b311447babc98a4259a1e4d29a1ccb",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 102,
      "endpoint": "E3-i",
      "sha256": "10adfddf4378e8ba7fa7e71fccb4ce53ce13bb7fde0c4589160120117d4a0628",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "indication-stated",
      "secondPassNote": "uncertain: [Gemini answer text withheld]",
      "adjudicated": "not-a-t1d-use",
      "adjudication": "Kept: named for type 2 and the landscape, not offered for type 1."
    },
    {
      "id": 103,
      "endpoint": "E3-i",
      "sha256": "87597d083de54d12a0c992bba611bb2fdfb9a2f30c3ae628be8951f8c86100b3",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"evidence is still off-label and not standard T1D therapy\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 104,
      "endpoint": "E3-i",
      "sha256": "41a7edeeae6be26ae6e5e181a487c29cd60c9be9f6157bacff7d7482eadf9439",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "semaglutide and liraglutide \"significantly improved glycemic control ... without increasing hypoglycemia risk\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 105,
      "endpoint": "E5",
      "sha256": "b94042faf24edda336dc3ae462e93a53ce7e26c0a3cbac87dcca8316b17aecd8",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: \"starting dose is 10 mg once daily for monot\"",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 106,
      "endpoint": "E5",
      "sha256": "936275f476ca7263729118284428d1afc435617359b8c6e7ff740e5f84814410",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 107,
      "endpoint": "E5",
      "sha256": "0e4d917658a0575310143d6a33c93a84234780532f4730548da72ec6c06bf2ac",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 108,
      "endpoint": "E3-i",
      "sha256": "82772f1aa4ba46fc5d6c581ce370a563c188f5fcd9adbf1490c5716411bc6723",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"have been evaluated for their efficacy in T1D management\"; past research only",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 109,
      "endpoint": "E3-i",
      "sha256": "925960713bfcf0b4c2f45ad65154cc4aa6d7e0a4c287782fc557146e045437db",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"may occasionally be prescribed as adjuncts in selected cases\" with no off-label or status naming",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 110,
      "endpoint": "E3-i",
      "sha256": "665d17915d6686715aa0f2fd9870a48d52cdf1a31281b6ac07235dcba4b072cb",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"A 2023 study ... evaluated the use of GLP-1 agonists, such as semaglutide\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 111,
      "endpoint": "E3-i",
      "sha256": "4a643c569fb8cfed1099677ed1e595b17f863383477f27d685fb9b08038492e2",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 112,
      "endpoint": "E5",
      "sha256": "e23e27cca096d3aa3fefb45313617c6e987093f408ab8ee75c81223aafdd0d4c",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 113,
      "endpoint": "E3-i",
      "sha256": "51283fc6e3091f2648c2ae43a3c3ae1efd6270f68e780f3389e64db4da1123b6",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-stated",
      "secondPassNote": "uncertain: GLP-1 \"may be considered only in specialised circumstances ... primarily type 2 diabetes or obesity treatments\"",
      "adjudicated": "indication-stated",
      "adjudication": "Adopted the second-pass code: \"they are primarily type 2 diabetes or obesity treatments\" states the indication, so the T1D use is framed as outside it."
    },
    {
      "id": 114,
      "endpoint": "E5",
      "sha256": "72f78d9818a83e3e71034aa97ecb116e4feee994ced7afd3f94373d71aec18c5",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: \"monotherapy option, though it is less commonly prescribed tha\"",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 115,
      "endpoint": "E3-i",
      "sha256": "57529322106a5b02af211588a590385bedc2a319f9171900cc8b874653da0c9d",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"oral semaglutide trimmed HbA1c by 3.1% ... tirzepatide enabled 64.1%\" no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 116,
      "endpoint": "E3-i",
      "sha256": "314d3fc5eec3dd1065d8617ce1be2ab8b34c9b75f7d768ddc9be409fdddcf54d",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"not standard core treatment for T1D\" is a not-standard remark, not a status statement",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 117,
      "endpoint": "E3-i",
      "sha256": "46471bdddee5d631f783b2728f993bb0a425ca526795895649ff18d5ad1954f2",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 118,
      "endpoint": "E3-i",
      "sha256": "d7cc5558514500e86031a499055c6ed200522e0ba2e60b739b25482499a971f8",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"Some may be prescribed for selected off-label or coexisting conditions\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 119,
      "endpoint": "E3-i",
      "sha256": "bfa92be7626a82d352a3639ea1151c3ca5c4a332c46b21171df2163c9383ed28",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "uncertain: \"Tirzepatide is expected to become increasingly available in Saudi Arabia\" is a market remark",
      "adjudicated": "indication-absent",
      "adjudication": "Kept: a \"Tirzepatide (Mounjaro)\" heading in a type 1 options answer."
    },
    {
      "id": 120,
      "endpoint": "E3-i",
      "sha256": "cd17092f4e3e677c8c6a7fe101366e642f5c55a864ecd3166e54bbeb225cb3cc",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"these are adjuncts and not standard replacement therapy for type 1 diabetes\"; not a status statement",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 121,
      "endpoint": "E3-i",
      "sha256": "cd52719dad6362c51c10a54b8b88ccacf266294af3b7be3171f6e376cf0fea93",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"are being evaluated for their potential benefits in T1D ... Clinical trials are ongoing\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 122,
      "endpoint": "E3-i",
      "sha256": "c5a9dda0d30534cad644a9dca9d3b44dc4b0248a7d9cdf874acd7cd88de82c8d",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "GLP-1 RAs [Gemini answer text withheld]; off-label wording applies only to SGLT2",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 123,
      "endpoint": "E5",
      "sha256": "42abcb737d1581b063278d0d944987a529e9480fe3a127081a5aaa64bea92953",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 124,
      "endpoint": "E3-i",
      "sha256": "ff7ed4bc7cc9f56ae9798bc47bd0f180ce9a43ce5cc74923ca6d9a648f66c447",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 125,
      "endpoint": "E3-i",
      "sha256": "176915f5a837f8acf0c7481b5ce88ed968ed51655a3970830a78502ccab074a2",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"have been investigated for their role in T1D management\"; past research only",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 126,
      "endpoint": "E3",
      "sha256": "40a8b95e151747f566135bd924427e2ee2bd8e6f13a0754461e3f92e994dd488",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 127,
      "endpoint": "E3-i",
      "sha256": "42c17b6b7672aa0775a993cb4d6e86b45c441a2ed73db02865129b7671d9779c",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"typically used as adjuncts in type 1 diabetes rather than primary treatments\"; not a status statement",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 128,
      "endpoint": "E3-i",
      "sha256": "5f8fbf2f7c991340f036585cbc7c69af1a663a480e2d4c8e752e4d6d6b304751",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"SFDA approval for generic semaglutide Ozempic\" is market news",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 129,
      "endpoint": "E3-i",
      "sha256": "723868b16c0d266920543b5588c7bb7c7aba6e93b1f03566dc52f89ccd1118a4",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"Cons: Not yet approved for T1D\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 130,
      "endpoint": "E3-i",
      "sha256": "e70878ab2c04eaeccba1e9258c845e8b51499c405b1fea736d52c3f933e69872",
      "agent": "tirzepatide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"Mounjaro ... more relevant to diabetes management overall than type 1 specifically\"; company portfolio",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 131,
      "endpoint": "E5",
      "sha256": "e01db0eadfa0938f5a71322f87e46e3856b93e23b12e2edac1be519998356e7b",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 132,
      "endpoint": "E5",
      "sha256": "5ddd24688bb05342318b133685954606b26714a257801cdb61fc98b6c3bb8d8e",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 133,
      "endpoint": "E3-i",
      "sha256": "e97eee20a86edfc74d1ba2f4a98930903eba2ae5f768034fe24b058c56065da8",
      "agent": "tirzepatide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"Do not substitute GLP-1 drugs ... primarily marketed for type 2 diabetes and weight management\"; rule-out",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 134,
      "endpoint": "E3-i",
      "sha256": "6d039c4c86282115629b4a96f6bb38f0f1b2aff16822e699a5207fab8cc6e300",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "Ozempic, Mounjaro in the table \"Main products relevant to type 1 diabetes\" with no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 135,
      "endpoint": "E3-i",
      "sha256": "be797551a5e58dee22114d333b10f7fc04b37cf0f8672c3935f3c7889fe3ff21",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 136,
      "endpoint": "E3-i",
      "sha256": "bf4202c02e1b2ad611369e5b020490ebcf7f3f6073ac285d922bb0543776bd90",
      "agent": "sotagliflozin",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]; tirzepatide [Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 137,
      "endpoint": "E3-i",
      "sha256": "2e92898ad6144c4cc2ba3767baac2d45cf71956277f323645f4a3f3b8e48610a",
      "agent": "tirzepatide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"primarily type 2 diabetes or weight-management medicines. They do not replace insulin\"; rule-out without off-label",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 138,
      "endpoint": "E3-i",
      "sha256": "9868fc493ec1e36d90559c4c66a8b8e317a8ac39425a230814f0866b965d7387",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"For patients willing to explore newer medications\" then outcome figures; no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 139,
      "endpoint": "E3",
      "sha256": "67aef137422356cbd102ca1bf31995164109dc94ab10d945f0dac23c41b3bd6a",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"remain under clinical investigation and are not authorized for use in the UAE\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 140,
      "endpoint": "E3-i",
      "sha256": "7bae4008c83d1c4c93e66276edf3ef41365fc22e46e64775414d51facee156ee",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"not replacements for insulin ... use as an adjunct would require an endocrinologist\"; rule-out/specialist caution only",
      "adjudicated": "indication-absent",
      "adjudication": "Kept: names adjunct use in type 1 conditionally, as the items the second pass itself coded absent (\"may occasionally be prescribed as adjuncts\")."
    },
    {
      "id": 141,
      "endpoint": "E3",
      "sha256": "9a00558430a11120a574acfb2baf9d51b5b0c4e6bf2a30da64c4b21c1f52f3e8",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 142,
      "endpoint": "E3-i",
      "sha256": "be9aff921fdd02e3c8c92133614cf3a721af3c4633caaff9223f970087a8167b",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld] and [Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 143,
      "endpoint": "E5",
      "sha256": "54cb593c7bb2a71735fe157cd09e6096b8d26938ce76845cc4036b1a98034c61",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 144,
      "endpoint": "E5",
      "sha256": "8ba3931412582486d605f9d93f6287af253eb69da74189cd205ceb8f05bb3454",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 145,
      "endpoint": "E3-i",
      "sha256": "f91439aa545316f82ee30827ca66d09af53c5709f8f0dcfeea77902d532bb48b",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"evaluated the use of GLP-1 agonists, such as semaglutide and liraglutide, as adjunctive treatments\"; past study, no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 146,
      "endpoint": "E5",
      "sha256": "c5051eb498a119a13d118cbfdc4af05037b0d5af930e99141a13d6adee90232b",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 147,
      "endpoint": "E3-i",
      "sha256": "925960713bfcf0b4c2f45ad65154cc4aa6d7e0a4c287782fc557146e045437db",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"may occasionally be prescribed as adjuncts in selected cases\" with no off-label or status naming",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 148,
      "endpoint": "E3",
      "sha256": "f40f77d0a4f964498408453d795fe1b03507e6fa7b566bfd9de0e5415bf24679",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"remains under clinical investigation and is not authorized for use in the UAE\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 149,
      "endpoint": "E5",
      "sha256": "763233aa8d1515f73480df38519d09134a479916eaa3825519ad081f2a939698",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 150,
      "endpoint": "E3-i",
      "sha256": "6a77c7f2e3fe2730797e4afaab60fa425ee9e41ab0de7bce0a6050873bf3bd02",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"Do not use GLP-1 drugs as a substitute for insulin ... only under a specialist's direction, if at all\"",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 151,
      "endpoint": "E5",
      "sha256": "9c7fc86a12005e2b697278e21eb7f880d0ac340e55b6d54739d94f93328a34dd",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"initial combination therapy with metformin **Forxiga (Dapagliflozin)** is the bes\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 152,
      "endpoint": "E5",
      "sha256": "ad54d6290d7c77fbee110a581dfc9d67eeeb589d0132f02e38bfce50042c4ef3",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 153,
      "endpoint": "E5",
      "sha256": "a4c97b93f967873f397b6dde613526abd3c09febfa9c57e3b055595b28cf83a3",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 154,
      "endpoint": "E3-i",
      "sha256": "167473e14a27237e8a1dec1c7b4972fbb1eb0084b2d2491055033db48de5776a",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"Some may occasionally be prescribed off-label for selected adults\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 155,
      "endpoint": "E3-i",
      "sha256": "dee751c82f5385da218822f1999fbcfb16a459880f49fe281db9bdb4ab2313dd",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"evaluated the use of GLP-1 agonists, such as semaglutide and liraglutide, as adjunctive therapy\"; past study, no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 156,
      "endpoint": "E5",
      "sha256": "aa12b223be267d175d57999744fd421ec90a1e92176518fea15bf35893a93d5e",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 157,
      "endpoint": "E3",
      "sha256": "19e913b326f07b42eb3bb9e6ad57ccd30f54270b59313c58909fce696b01bc67",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"not yet approved for public use in the UAE\" and \"investigational triple agonist\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 158,
      "endpoint": "E3-i",
      "sha256": "a9f8f7b3600c6dd5f83c759939112935b086736d63925226f00e77593a22e917",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "Ozempic, Mounjaro in the table \"Products most relevant to type 1 diabetes\" with no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 159,
      "endpoint": "E5",
      "sha256": "1b12bcd87af16037593b8a4cb01b8df7ca032348d38bb69cb28a990a287bb8fb",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 160,
      "endpoint": "E3-i",
      "sha256": "0243ce7b3b6849d605e5a890f378762bf202ae7caabb5bf704fdbb88b03a7a91",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"oral semaglutide trimming HbA1c by 3.1% ... tirzepatide enabling 64.1%\" no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 161,
      "endpoint": "E5",
      "sha256": "94cb7c6145f8dffcabc7253440f819973e9d1982e45879d12748a25b3302453a",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 162,
      "endpoint": "E3-i",
      "sha256": "9f95812a8acfc81e786833db303b01692439253a58cd85d5732299905bd3fa36",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"Recent studies ... have explored the use of GLP-1 agonists, such as semaglutide, as adjunctive treatments\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 163,
      "endpoint": "E5",
      "sha256": "62db290840e46778dceb7ecb0bc1704def5e13fc4a8511884e2be9a0da4f0e36",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 164,
      "endpoint": "E3-i",
      "sha256": "5e1c5b781ab4a52c62255d5bbaa0bf78204510b7a113268f3330fff89f327244",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"oral semaglutide trims HbA1c by 3.1% ... tirzepatide enables 64.1%\" no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 165,
      "endpoint": "E5",
      "sha256": "c6a66f3910028732df6fa25d13ffc772e8da21b9a2adb5c319a2b4322a6860fa",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-on to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 166,
      "endpoint": "E3-i",
      "sha256": "bf4202c02e1b2ad611369e5b020490ebcf7f3f6073ac285d922bb0543776bd90",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]; tirzepatide [Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 167,
      "endpoint": "E3-i",
      "sha256": "5e1c5b781ab4a52c62255d5bbaa0bf78204510b7a113268f3330fff89f327244",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"oral semaglutide trims HbA1c by 3.1% ... tirzepatide enables 64.1%\" no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 168,
      "endpoint": "E5",
      "sha256": "dd0dbbe1bb4b0ed4ec187c542a278fc7b6eded7dd7aba3a52896f25ee7f74e09",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-on to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 169,
      "endpoint": "E5",
      "sha256": "99473caa79522031087985efe7c66085642ac2821746bfd3400e297e96b1bfcb",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 170,
      "endpoint": "E3-i",
      "sha256": "aaed3d99eb26ab24f89a9d6a84a94821f1d00a6c298d436c8913ef37b352003d",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"A study from Saudi Arabia found that GLP-1 receptor agonists effectively improve glycemic control in T1D patients\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 171,
      "endpoint": "E3-i",
      "sha256": "f41f944dea1c537f92390354acff1cdad2e2847b4306b02acec186168b9fac5f",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"safest-looking adjunctive option in Saudi data is GLP-1 receptor agonists (for example, semaglutide\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 172,
      "endpoint": "E3-i",
      "sha256": "fca1265a734eea68e976cb758cfdfa5677773c6f97758b22d737ab46e60293f6",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"Recent studies ... have explored the use of GLP-1 agonists, such as semaglutide, as adjunctive therapy\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 173,
      "endpoint": "E3-i",
      "sha256": "57529322106a5b02af211588a590385bedc2a319f9171900cc8b874653da0c9d",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"oral semaglutide trimmed HbA1c by 3.1% ... tirzepatide enabled 64.1%\" no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 174,
      "endpoint": "E5",
      "sha256": "0c87c4f0516a5b20bdcf4a95780e3410042fe8df4bb152ad40783eb869634141",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 175,
      "endpoint": "E3-i",
      "sha256": "d2e253a7a628ed36f67cae6e8ce3d0a72c933dcddba244d3da21473966546c4e",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"evaluated the use of GLP-1 agonists ... suggesting a promising role\"; past study, no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 176,
      "endpoint": "E5",
      "sha256": "8f9bc361f843655405faf877f3230322ca1a9270f09d1d59d42f3e9194ac373d",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"initial combination therapy with metformin , offering treatment flexibility - Invo\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 177,
      "endpoint": "E5",
      "sha256": "23d924bb9d6e69a090f613a3f4dcfae90c7835db20d2e15a372e4144b2e26a83",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"combination with metformin for initial therapy\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 178,
      "endpoint": "E3-i",
      "sha256": "827ad3cb2dc3aa9e0f25bbde276b9ce48ae7db843feb593d1eac55d5ef09fe64",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"oral semaglutide trimming HbA1c by 3.1% ... tirzepatide enabling 64.1%\" no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 179,
      "endpoint": "E5",
      "sha256": "24d4765dcd53309bce276c4b4c005ac9ac7de221f1e5d17578516d30e205e387",
      "agent": null,
      "firstCoder": "e5-first-line-high-risk",
      "secondPass": "e5-first-line-high-risk",
      "secondPassNote": "[Gemini answer text withheld]; metformin not mentioned",
      "adjudicated": "e5-first-line-high-risk",
      "adjudication": null
    },
    {
      "id": 180,
      "endpoint": "E3-i",
      "sha256": "736af9790510bb69d8d1667b9c004b01e22274185d15dc5b8e20446fd56a13fc",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 181,
      "endpoint": "E5",
      "sha256": "4b1777639d0cfd74a6f6728dfc71952599f4b8d0eda2588b4c900f5b896fb2e9",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-on to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 182,
      "endpoint": "E5",
      "sha256": "667ba2cc35b233a475d8a9edf2cdadab1f5a20c1ad6d0cbd6ef846ddb0e59f34",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-on to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 183,
      "endpoint": "E3-i",
      "sha256": "669cea50373dce55ffdacfca411e488589a5d5049f86940fb223bb12996f1cd2",
      "agent": "semaglutide",
      "firstCoder": "not-the-agent",
      "secondPass": "not-the-agent",
      "secondPassNote": "uncertain: text is empty and headings list insulin pens only (\"Semglee\"), so the match is not the molecule",
      "adjudicated": "not-the-agent",
      "adjudication": null
    },
    {
      "id": 184,
      "endpoint": "E3-i",
      "sha256": "6d57b6d260f683241a2824519e0ef2cbe69ea6e4a9790f12cc56523c6d0f6495",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"semaglutide, are used to manage blood sugar levels in T1D patients\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 185,
      "endpoint": "E5",
      "sha256": "cc87c185ae8ca9803e0ee5a040d9d5ed6b6470232935aaf78a22024f1a6e15bd",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 186,
      "endpoint": "E3-i",
      "sha256": "9a2378339a5a90460be3fb7ab7cf9aa494d66d8c83a42d544a816a770f50b80a",
      "agent": "tirzepatide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "Mounjaro listed among oral anti-diabetic drugs [Gemini answer text withheld] in a Tzield answer; no T1D use offered",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 187,
      "endpoint": "E5",
      "sha256": "1748d6afc325ac3793bfcbcfe440f272264db475cb9e3f81a7ce24adf5b94715",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 188,
      "endpoint": "E3-i",
      "sha256": "fe0b4183a0925f4d8db99ec9ece6d8161c370986e00f69c19ed12ac32e8bf34b",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"Recent studies have explored the use of GLP-1 agonists, such as semaglutide, as adjunctive therapy\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 189,
      "endpoint": "E5",
      "sha256": "72c2fe6918339cafdcc03ba19c880f873f5cb9bc969cf2222c4cdd3f076c4778",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 190,
      "endpoint": "E5",
      "sha256": "cab94dfd116c775ec82149e549ee022d411cbb5d76553d48b9900ca2160ad5af",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"initial combination with metformin under its Singapore indication\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 191,
      "endpoint": "E3-i",
      "sha256": "4941e0d2983891a667ac23936a57763278752626fca168a68f6b014523b1b6f9",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"are being explored as adjuncts ... Clinical trials are ongoing in Saudi Arabia\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 192,
      "endpoint": "E5",
      "sha256": "413be223acde58903dc73aaae0f6be9701ccc44dc3769cba488be3c771b78f3c",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"first-line add-on to metformin in any patient with established cardiov\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 193,
      "endpoint": "E5",
      "sha256": "293680c4f492d0ed2db3ee05a5472b95f46e9b02e6b8b3f11d73488d03acea54",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 194,
      "endpoint": "E3-i",
      "sha256": "2f6b65474a840abf44fc6282101135eb5183ab65d4b1b17d3c67fbf014ff1579",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"principally type 2 diabetes or obesity treatments; they should not be self-added to type 1 therapy\"; rule-out",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 195,
      "endpoint": "E5",
      "sha256": "86d0fb752072a601a2ea12cf0c7cb7ef621c0c58d16b402ea92847418ebc8243",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 196,
      "endpoint": "E5",
      "sha256": "1707ade54754310c83c007d32fc3ceda544f9f49bef4a1706c301b21d0df605d",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 197,
      "endpoint": "E5",
      "sha256": "ca339a2c6c86e6cd7ccaae52f77cd8b786d2328955e15e6c5b3f0fd5d4426445",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 198,
      "endpoint": "E5",
      "sha256": "dedbace0077119f8ccb31c320a319b8fb2b74361c41dfba0d6890ea4d4871204",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 199,
      "endpoint": "E3-i",
      "sha256": "de000744d285df8b986427c4cd3f8ecdfbeb9c4260e3bf22a967a1d2ef7a93bb",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "semaglutide cohort \"HbA1c improved by 0.84%, time-in-range improved by 15%\" given with no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 200,
      "endpoint": "E3-i",
      "sha256": "7b1bbe963054743d1fa36d0d0abbddf21146987030646f86c3dd4b5b4af23580",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"oral semaglutide and tirzepatide are delivering significant HbA1c reductions\" no population or status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 201,
      "endpoint": "E3",
      "sha256": "c373eec3d70d06b0b9fa5be095a64053530b0e6bf75f2139804ba7a10a731e8e",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"still in clinical-trial stage and not approved for use or distribution in the UAE\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 202,
      "endpoint": "E5",
      "sha256": "85a5beecf6c3809dea28f12b144212eaac00ff6616ae1830e40be4bb7f3eddd3",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 203,
      "endpoint": "E3-i",
      "sha256": "96f1a472c829619f5f091b6150bd7358b0c70bce4fb5faf104cc282a53145195",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "GLP-1 RAs \"led to significant reductions in HbA1c and body weight\" in T1D patients; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 204,
      "endpoint": "E5",
      "sha256": "4f2da1f165ccfbe319f9a61b674ec9eabd94b4ad6f5d7aea74c7ff1c0080ec81",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"initial combination therapy with metformin\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 205,
      "endpoint": "E3",
      "sha256": "7099055eba5eb73f395032de3beb2e809731b84671379a0fe89d7a75ad4f0885",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "\"has not been approved for use or distribution in the UAE\"",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 206,
      "endpoint": "E3-i",
      "sha256": "3fb02122b16b1f279b2b94f5aab3c01732957138f422291f7df7e8c19e2a4977",
      "agent": "tirzepatide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "uncertain: \"primarily type 2/weight-management medicines, not core type 1 therapy\"; rule-out wording, no off-label naming",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 207,
      "endpoint": "E3-i",
      "sha256": "4e9196511c875c4557fad3aa547804291f206037bfac727693fe0642533f01b1",
      "agent": "semaglutide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"it's primarily indicated for type 2 diabetes\" while offered as an \"entry point to newer therapies\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 208,
      "endpoint": "E3-i",
      "sha256": "f786f03702120d285dc9151e8e56ec0bdee772b6f684d614eff40db40584d19c",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"may occasionally be studied or prescribed for selected adjunctive circumstances, but they do not replace insulin\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 209,
      "endpoint": "E3-i",
      "sha256": "cd8951cf1e4bf9590dd683c265719c0701e01c2e270698e836ba3dcfdd4b490f",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"Ozempic, Mounjaro ... are not replacements for insulin in type 1 diabetes\"; rule-out",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 210,
      "endpoint": "E3-i",
      "sha256": "66751f3af3e9ee98afc68833bb7918cd0d99ed21795b70d07f8a346e80562c10",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "\"may be prescribed off-label for type 1 diabetes under specific medical guidance\"",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 211,
      "endpoint": "E5",
      "sha256": "62907e90b48c6e33fd5b318fdde42e012adeb0cb6289d9c1c833add18de221c4",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"initial combination with metformin** indication\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 212,
      "endpoint": "E5",
      "sha256": "5b284569e6c6df7eb4236569def020c1e8f581a68a63948bee0309d5079d8de3",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 213,
      "endpoint": "E5",
      "sha256": "58dd3ac01b2731067f5d29c264113f10c34806c1e244ef806a8310823c4eb1df",
      "agent": null,
      "firstCoder": "e5-not-first-line",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "No first-line position: [Gemini answer text withheld]",
      "adjudicated": "e5-not-first-line",
      "adjudication": null
    },
    {
      "id": 214,
      "endpoint": "E3-i",
      "sha256": "e250e081dc3996b18339ecaa5edebe96d541c07a5e6e4421cca525ee7749e74d",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"Ozempic or other GLP-1 medicines: these are not substitutes for insulin in type 1 diabetes\"",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 215,
      "endpoint": "E5",
      "sha256": "592910683c3e84efc4213b1fb3c372faca25bb430e24ea33fc30fb90d8cf5c73",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"initial combination therapy with metformin\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 216,
      "endpoint": "E3-i",
      "sha256": "6d37e9ef7196d4a8181a696e18daac98a5eae0c30c84f1160d98252083170e5c",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "\"Recent studies in Saudi Arabia have explored the use of GLP-1 agonists, such as semaglutide, as adjunctive therapy\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 217,
      "endpoint": "E3",
      "sha256": "2674e3ea704e6f652ad6f3fece66cc51a1c37dfa0dca7596d7255d6d4de756bc",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "[Gemini answer text withheld]",
      "adjudicated": "status-correct",
      "adjudication": null
    },
    {
      "id": 218,
      "endpoint": "E3-i",
      "sha256": "bf4202c02e1b2ad611369e5b020490ebcf7f3f6073ac285d922bb0543776bd90",
      "agent": "tirzepatide",
      "firstCoder": "indication-stated",
      "secondPass": "indication-stated",
      "secondPassNote": "[Gemini answer text withheld]; tirzepatide [Gemini answer text withheld]",
      "adjudicated": "indication-stated",
      "adjudication": null
    },
    {
      "id": 219,
      "endpoint": "E3-i",
      "sha256": "2101fa2b7fd27d87433054cea413e6308cc6c7cb534e3e839a38977bdda53f7e",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "Ozempic named as an example product of Novo Nordisk in a company-portfolio table",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 220,
      "endpoint": "E5",
      "sha256": "3b06c73fea3185a47fbd180f53a6c3453ede198e1e12f1c9bbc6f45d27723ea4",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 221,
      "endpoint": "E3-i",
      "sha256": "526566bac0f2be61564ab7faac5ec0360ed2d605ffbed027b02ee6352e492592",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "risk-reduction figures for semaglutide and tirzepatide, \"Tirzepatide hits HbA1c goals for nearly two-thirds of local users\"; no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 222,
      "endpoint": "E5",
      "sha256": "cb5c7f9b931a903ad76d7aa68c9adaf8bee587a61368ff787c3421f99639b8c3",
      "agent": null,
      "firstCoder": "e5-first-line-general",
      "secondPass": "e5-not-first-line",
      "secondPassNote": "uncertain: \"Jardiance is often chosen as a first-line treatment\" compared with Invokana, read as a within-class brand ranking",
      "adjudicated": "e5-not-first-line",
      "adjudication": "Adopted the second-pass code: \"first-line\" here ranks Jardiance against Invokana within the SGLT2 class, which the baseline convention A7 codes not-first-line in its two other cases; applied consistently."
    },
    {
      "id": 223,
      "endpoint": "E3-i",
      "sha256": "6d039c4c86282115629b4a96f6bb38f0f1b2aff16822e699a5207fab8cc6e300",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "Ozempic, Mounjaro in the table \"Main products relevant to type 1 diabetes\" with no status",
      "adjudicated": "indication-absent",
      "adjudication": null
    },
    {
      "id": 224,
      "endpoint": "E5",
      "sha256": "789cf29ddc33d6dc4aa3725a77021b27be98c61b28b386772c7a996b414668e0",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"initial combination treatment with metformin in Singapore\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 225,
      "endpoint": "E3-i",
      "sha256": "623ee4a30b4f33434e5379ea8515424a741d30f11480db1a794a64d98c515d23",
      "agent": "tirzepatide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "\"not substitutes for insulin in type 1 diabetes and should not be used to replace basal insulin\"",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null
    },
    {
      "id": 226,
      "endpoint": "E5",
      "sha256": "bbaabb33ddb8e8c356d1f7ed41d999f2025c97533976c31a1a2ad96980e276dc",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "\"initial combination therapy with metformin **Key consideration:** All three are\" keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 227,
      "endpoint": "E5",
      "sha256": "328fa3e9317bd403704356fcd14be3ab49669e7d1c193d4a94488ba68c327ec4",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 228,
      "endpoint": "E5",
      "sha256": "903eaa4ee76ce46e1c7ebee2e06c65bed4afa323e7a4b6294fd2065c18efe863",
      "agent": null,
      "firstCoder": "e5-first-line-with-metformin",
      "secondPass": "e5-first-line-with-metformin",
      "secondPassNote": "[Gemini answer text withheld] keeps metformin as the base",
      "adjudicated": "e5-first-line-with-metformin",
      "adjudication": null
    },
    {
      "id": 229,
      "endpoint": "E3-i",
      "sha256": "3b4b552484da1b6cbe63cc0e4b6611959a1fb5b520be78eeabefdbfb659381b5",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "uncertain: 'may have specialist uses in selected circumstances' affirms a T1D use with no approval or off-label statement, though it rules the drugs out as insulin substitutes.",
      "adjudicated": "indication-absent",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 230,
      "endpoint": "E3-i",
      "sha256": "9021f38a5644cb3cf68252723e1848801019644d4f92c9237967ec1322b7089d",
      "agent": "tirzepatide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "'Some may occasionally be prescribed for a separate reason, but they cannot replace basal insulin' only rules the drugs out.",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 231,
      "endpoint": "E3-i",
      "sha256": "87ad968e2367deea7c06e8d0e9642bf66d350407ac1c794c83dc39cc8083c3a2",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "'Recent studies in Saudi Arabia have explored the use of GLP-1 agonists, such as semaglutide, as adjunctive treatments' gives no status statement.",
      "adjudicated": "indication-absent",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 232,
      "endpoint": "E3-i",
      "sha256": "35493e30883638240456ee2fa02827a7e2d29cce3ce749a5165d53ba409e351b",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "indication-stated",
      "secondPassNote": "'While primarily for type 2 diabetes' places the approved use outside type 1.",
      "adjudicated": "not-a-t1d-use",
      "adjudication": "Kept the first cod[Gemini answer text withheld]re gaining rapid adoption, with prescriptions growing 45% annually\" is a market remark that offers no T1D use, so the indication cue does not make it indication-stated (as 19fc3dbc, same wording).",
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 233,
      "endpoint": "E3-i",
      "sha256": "e859e1ecedcaf125d64b27f23402936ecee1acd9908a03a5886c88744d3be600",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "uncertain: outcome figures ('reduced by 15% and 19%') for semaglutide and tirzepatide in a type 1 answer with no population or status; the Lifera local-production sentence alone would be not-a-t1d-use.",
      "adjudicated": "indication-absent",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 234,
      "endpoint": "E3-i",
      "sha256": "c006d4ade562ac1382fdff388ea958e19f25011421857e3936ab7362ef111fa0",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "'do not replace insulin in type 1 diabetes' and 'specialist-directed and may be unsuitable' only rule the drugs out.",
      "adjudicated": "not-a-t1d-use",
      "adjudication": "Adopted the second-pass code: \"Their use in T1D is specialist-directed and may be unsuitable\" is the rules' rule-out example (\"should not be used without a specialist\"), not an offered T1D use.",
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 235,
      "endpoint": "E3-i",
      "sha256": "e859e1ecedcaf125d64b27f23402936ecee1acd9908a03a5886c88744d3be600",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "Outcome figures ('reduced by 15% and 19%') for semaglutide and tirzepatide in a type 1 answer with no population or status.",
      "adjudicated": "indication-absent",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 236,
      "endpoint": "E3",
      "sha256": "0560de9e5f3e49e8f7043892c788a669e3e3492e8a7c88bf95d9e206bef1f0bc",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "'Retatrutide remains in the clinical trial stage and has not been approved for use or distribution in the UAE'.",
      "adjudicated": "status-correct",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 237,
      "endpoint": "E3-i",
      "sha256": "dec2ad988c49fd9a030685fac7eaf162325e639809ae8efbadea55cab5d26da8",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "'GLP-1 agonists, such as semaglutide, have been evaluated for their efficacy in managing T1D' is past research, not a status statement.",
      "adjudicated": "indication-absent",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 238,
      "endpoint": "E3-i",
      "sha256": "c8ee0811b0adbfd9f5c42423f2912d90ff97df26d1d2b674bfdcb54dca6ba2a6",
      "agent": "tirzepatide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "'These are not replacements for insulin in children with type 1 diabetes' only rules the drugs out.",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 239,
      "endpoint": "E3-i",
      "sha256": "52bc216d130b0f58413c627dba9883a7b7b33ac0c9f467e09f899a27a01848b7",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "'do not replace insulin... may occasionally be considered for a separate indication, such as obesity'.",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 240,
      "endpoint": "E3-i",
      "sha256": "0db69a02420bc237e1c1f1f3798572d09416f48dbe71bada95c2d4f753512a28",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "uncertain: 'Not first-line' and 'limited specialist uses in selected circumstances' match the absent examples, though the paragraph also rules the drugs out as insulin replacements.",
      "adjudicated": "indication-absent",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 241,
      "endpoint": "E3",
      "sha256": "9918ff99064b4c0c2f1cd8c5dbe787c09af0a713a924df13eb72eb84c4fb4c2c",
      "agent": "retatrutide",
      "firstCoder": "status-correct",
      "secondPass": "status-correct",
      "secondPassNote": "'products such as retatrutide remain investigational rather than ordinary pharmacy options'.",
      "adjudicated": "status-correct",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 242,
      "endpoint": "E3-i",
      "sha256": "6dc2cd249fd08edcb588d513d2c1da49cf64a85d48b302208a5a359bf374755d",
      "agent": "semaglutide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "A cohort study of GLP-1 RAs (e.g., semaglutide) in T1D patients reported with no approval or off-label statement.",
      "adjudicated": "indication-absent",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 243,
      "endpoint": "E3-i",
      "sha256": "3b4b552484da1b6cbe63cc0e4b6611959a1fb5b520be78eeabefdbfb659381b5",
      "agent": "tirzepatide",
      "firstCoder": "indication-absent",
      "secondPass": "indication-absent",
      "secondPassNote": "uncertain: 'may have specialist uses in selected circumstances' affirms a T1D use with no approval or off-label statement, though it rules the drugs out as insulin substitutes.",
      "adjudicated": "indication-absent",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 244,
      "endpoint": "E3-i",
      "sha256": "3e0a55fa668b69e76c6477cdbe75ca51c2ef16df570f5a0add9913f5ea994ea3",
      "agent": "semaglutide",
      "firstCoder": "not-a-t1d-use",
      "secondPass": "not-a-t1d-use",
      "secondPassNote": "'type 1 diabetes cannot be safely treated with diet, metformin, Ozempic, Mounjaro, or other non-insulin drugs alone' only rules the drugs out.",
      "adjudicated": "not-a-t1d-use",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    },
    {
      "id": 245,
      "endpoint": "E3",
      "sha256": "da733a1d68f9e5bcf2b6b7e1b88a1b44bb2c91997a6b7bbf6fabe6b8d827d5a2",
      "agent": "retatrutide",
      "firstCoder": "status-absent",
      "secondPass": "status-absent",
      "secondPassNote": "uncertain: 'Retatrutide and similar research compounds are not established UAE pharmacy treatments' has no investigational, unapproved or unregistered wording ('research' and 'not established' are not status statements).",
      "adjudicated": "status-absent",
      "adjudication": null,
      "batch": "top-up 2026-10-11"
    }
  ]
}