{"publication_id":"9ff9a2ac-5a2c-4db3-8004-dff34731a3f4","screening":{"identified":29,"screened":29,"excluded":0,"included":29,"included_or_retained":29,"flow":["identified","screened","excluded_with_reasons","included"],"wording":"29 candidate receipts retained after source retrieval, deduplication, and topic filtering. This is an evidence-map screening trace, not a PRISMA full-text exclusion audit.","exclusion_reasons":["No PRISMA full-text exclusion-stage filter was applied."]},"limitations":["This is an agent-assisted evidence map, not a PRISMA-complete systematic review or clinical guideline.","It is not PROSPERO-registered and should not be read as medical advice.","Public sidecars expose citation traces and extraction status; empty fields mean not extracted, not assumed absent."],"contradictions":["Semaglutide 2.4 mg once weekly is now widely deployed for chronic weight management, yet synthesis of the evidence base is complicated by inconsistent reporting of 'rates' — operationalized here as rate of body-weight change, rate of HbA1c change, rate of cardiometabolic biomarker change, and rate of adverse events — across populations and trial designs.","We conclude that the 2.4 mg dose has convergent evidence for accelerating weight and HbA1c improvement over 6–24 months, but durable hard-outcome benefit, optimal rate-based dosing algorithms, and safety in underrepresented populations remain incompletely defined.","The corpus contains 6 direct clinical sources, 23 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence.","Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection.","The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific.","The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect.","The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty.","Findings Map accounting note: each outcome-class n, direction count, directness count, and source roster is computed from the same source-level rows listed in the detailed table. Receipt-level direction is not a statement that the source abstracts lack directional statistics; it is the conservative coded polarity used for synthesis accounting. Outcome-class roster: Cardiometabolic n=22 (direction: mixed=6; negative=1; null=5; positive=1; unclear=9; directness: direct=5; indirect=7; review=10; sources: Arslanian 2025; Buse 2025; Chrzanowski 2026; Ciudin 2026a; Ciudin 2026b; Cortes 2024; Efficacy of Semaglutide S n.d.; Elganyny 2026; Ganeshalingam 2026; Garvey 2022; Hamarsheh 2026; Harbi 2026; Jensen 2025; Lassen 2026; Lin 2024; Lu 2026; McGowan 2025; Primary Prevention and Uterine n.d.; Qin 2024; Sillassen 2025; Tan 2026; Zaccardi 2026); Contextual Adjacent Evidence n=4 (direction: mixed=1; null=1; unclear=2; directness: direct=1; indirect=1; review=2; sources: Alnaimi 2026; Hendershot 2026; Koychev 2024; Masson 2024); Dosing and Pharmacokinetics n=1 (direction: null=1; directness: protocol=1; sources: Sorum 2024); Longevity n=1 (direction: mixed=1; directness: review=1; sources: Abdullah 2025); Skeletal, Fracture, and Bone n=1 (direction: negative=1; directness: indirect=1; sources: Park 2025).","| Cardiometabolic | Arslanian 2025: Effect of Semaglutide on Insulin Sensitivity and Cardiometabolic Risk Factors in Adolescents With Obesity: The STEP TEENS Study | direction=mixed | directness=indirect | B2 | outcome=Cardiometabolic; direction=mixed | finding=representative statistic P = 0.0001; source-level statistic reported |"]}