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Cited by 70Attention Deficit Hyperactivity DisorderDevelopmental and Educational NeuropsychologyNeural and Behavioral Psychology Studies

Executive Function in Children with Attention Deficit/Hyperactivity Disorder: The NIH EXAMINER Battery

Open access
Schreiber, Jane E., Possin, Katherine L., Girard, Jonathan M., Rey-Casserly, Celiane·2014·Journal of the International Neuropsychological Society
DOI 10.1017/s1355617713001100PMC PMC4425416
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Abstract

Theories of attention deficit/hyperactivity disorder (ADHD) increasingly highlight the role of neuropsychological impairment in ADHD; however, a consistent and identifiable pattern of performance on tests is not well established. The National Institutes of Health (NIH) Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (EXAMINER) battery provides measures of common variance across multiple executive function tests within specific domains and was used to characterize which executive functions are most affected in children with ADHD. Thirty-two children (24 male), ages 8–15 years (M = 12.02; SD = 2.29), diagnosed with ADHD and no comorbid disorder completed the NIH EXAMINER battery. Sixty age and gender matched healthy controls were chosen from a database of participants enrolled in the NIH EXAMINER multi-site study. Children with ADHD performed worse on the working memory score compared with the controls. No differences were found on the cognitive control or fluency scores. For children with ADHD, poorer working memory performance predicted parent report of child learning problems. Cognitive control and fluency scores did not predict learning problems. In summary, working memory emerges as a primary impairment in children with ADHD who have no comorbid disorders. Furthermore, working memory weaknesses may underlie the academic problems often seen in children with ADHD. (JINS, 2013, 19, 1–11)

AI snapshot

Written from the paper’s full text.

TL;DR

In children with ADHD and no comorbid disorders, the NIH EXAMINER battery showed a specific working memory weakness relative to healthy controls, while cognitive control and fluency did not differ. Poorer working memory also predicted parent-reported learning problems in the ADHD group.

Key findings

  • Children with ADHD (n=32; 24 male; ages 8–15, M=12.02, SD=2.29) performed significantly worse than controls (n=60; ages 8–16, M=11.75, SD=2.53) on the working memory score; no significant group differences were found for cognitive control or fluency scores.
  • In the ADHD group, a hierarchical regression predicting parent report of learning problems found working memory was the only significant predictor; adding working memory explained an additional 23.8% of variance, and the final model was significant, F(4,27)=5.410, p=.002, with all four variables accounting for 44.5% of variation.
  • Cognitive control and fluency scores did not predict learning problems in the ADHD group.
  • Age and word reading did not differ significantly between groups: age t(90)=−.52, p=.61; word reading t(87)=−.83, p=.41.

Methods

  • Participants were 32 children diagnosed with ADHD by a pediatric neurologist according to DSM-IV criteria and without comorbid disorder, plus 60 age- and gender-matched healthy controls selected from the NIH EXAMINER multi-site study database. ADHD participants were recruited from Boston Children’s Hospital; controls came from three participating sites.
  • Executive function was measured with the NIH EXAMINER battery. Working memory included 1-Back, 2-Back, and Dot Counting; cognitive control included Flanker, Antisaccade, Set-Shifting, and a combined error measure; fluency included phonemic and category fluency. Scores were created using item response theory.
  • Group differences were tested with ANCOVA controlling for age. A four-step hierarchical regression, with age entered first, examined cognitive control, fluency, and working memory as predictors of parent-reported learning problems on the Conners 3-P Learning Problems subscale in the ADHD group.

Limitations

  • The paper states the sample size was very small, limiting separate analyses by sex and by ADHD subtype.
  • The paper states the broad age range (8–16 years) spanned important developmental periods, but the sample was too small to examine executive function deficits at different ages.
  • The paper states no IQ measure was included in the control group, so group differences could not be examined after controlling for IQ. Evident from the text: learning problems were assessed only by parent report, and the authors note they did not obtain school grades; controls were drawn from different sites and the samples were predominantly Caucasian.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1017/s1355617713001100

Cites

88 of 88 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 64 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In the final regression model, working memory was the only significant predictor of parent-reported learning problems among age, cognitive control, fluency, and working memory.

    “When all four variables were included in the step four of the regression model, working memory was the only significant predictor of learning problems.”
    Quote in the paperSubstantial claim
  • Findingown data

    Adding working memory to the regression model explained an additional 23.8% of the variation in parent-reported learning problems.

    “Finally, the addition of working memory to the regression model explained an additional 23.8% of the variation in learning problems, and the model was statistically significant F(4,27)=5.410, p=.002.”
    Quote in the paperSubstantial claim
  • Findingown data

    For children with ADHD, poorer working memory performance predicted more parent-reported learning problems.

    “For children with ADHD, poorer working memory performance predicted parent report of child learning problems.”
    • Also stated in: § Associations among Executive Function Factors and Learning Problems · plain
      “Children with poorer working memory had significantly more parent report of learning problems (See Figure 1).”
    • Also stated in: § Associations among Executive Function Factors and Learning Problems · plain
      “When all four variables were included in the step four of the regression model, working memory was the only significant predictor of learning problems.”
    Quote in the paperSubstantial claim
  • Findingown data

    There were no significant differences between children with ADHD and controls on cognitive control or fluency scores.

    “No differences were found on the cognitive control or fluency scores.”
    • Also stated in: § Group Differences in Executive Function · hedged
      “Results for the cognitive control and fluency scores indicated nonsignificant group effects.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The healthy control children selected from the multi-site database are comparable to the ADHD group on relevant characteristics other than age and gender.
  • Findingown data

    The four independent variables together accounted for 44.5% of the variation in parent-reported learning problems.

    “Together, the four independent variables accounted for 44.5% of the variation in parent report of learning problems.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 12
  • Classified as probably not a substantial claim. 19

  • May combine two claims.

    Premisecitation

    Attention problems predict poor academic progress in children with ADHD and in children below the diagnostic threshold.

    “Attention problems predict poor academic progress (Fergusson & Horwood, 1995; Fergusson, Lynskey, & Horwood, 1997; Merrell & Tymms, 2001; Galera, Melchior, Chastang, Bouvard, & Fombonne, 2009) in children with ADHD as well as in children below the diagnostic threshold (Breslau, et al., 2009; Currie & Stabile, 2006).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Fergusson & Horwood, 1995

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    • cites Fergusson, Lynskey, & Horwood, 1997

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    • cites Merrell & Tymms, 2001

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Learning disorder is a common comorbid diagnosis in children with ADHD, with 20-25% meeting criteria.

    “Learning disorder is a particularly common comorbid diagnosis, with 20–25% of children with ADHD also meeting criteria for learning disorder (Pliszka, 2000).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Pliszka, 2000 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Working memory is important for learning and acquiring academic skills.

    “research indicates that working memory is important for learning and acquiring academic skills (Alloway & Alloway, 2010; Gathercole, Pickering, Ambridge, & Wearing, 2004).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Alloway & Alloway, 2010

      Not checked in the free run.

    • cites Gathercole, Pickering, Ambridge, & Wearing, 2004

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    Controls were selected to roughly match the ADHD participants on age and gender, ensuring minimal group demographic differences, though matching was not exact for all cases.

    “Controls were selected to roughly match the ADHD participants with respect to age and gender. This ensured minimal group demographic differences; however, variable matching was not exact for all cases.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    ADHD is consistently associated with moderate weaknesses in response inhibition and working memory, as well as impulsivity, vigilance, organization, and some measures of planning.

    “A meta-analysis indicated that ADHD is consistently associated with moderate weaknesses in response inhibition and working memory as well as impulsivity, vigilance, organization, and some measures of planning (Willcutt, Doyle, Nigg, Faraone, & Pennington, 2005).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Willcutt, Doyle, Nigg, Faraone, & Pennington, 2005

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Academic difficulties are more related to inattention symptoms than hyperactivity symptoms.

    “Research suggests that academic difficulties are more related to inattention symptoms than hyperactivity symptoms (Breslau et al., 2009; Chhabildas, Pennington, & Willcutt, 2001; Rabiner & Coie, 2000).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Breslau et al., 2009

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    • cites Chhabildas, Pennington, & Willcutt, 2001

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    • cites Rabiner & Coie, 2000

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Working memory deficits have been linked to learning problems and poor school performance in children with and without ADHD.

    “working memory deficits have been linked to learning problems and poor school performance in children with and without ADHD (Alloway & Alloway, 2010; Alloway, Elliott, & Place, 2010).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Alloway & Alloway, 2010

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    • cites Alloway, Elliott, & Place, 2010

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The ADHD Rating Scale-IV has well-established psychometric properties.

    “Normative data based on age and gender are available, and the psychometric properties are well established (Collett, Ohan, & Myers, 2003; DuPaul, Power, Anastopoulos, & Reid, 1998).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Collett, Ohan, & Myers, 2003

      Not checked in the free run.

    • cites DuPaul, Power, Anastopoulos, & Reid, 1998

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The NIH EXAMINER provides a more comprehensive and in-depth measurement of executive functions than the NIH Toolbox, including working memory measures that tap both verbal and spatial modalities and emphasize updating processes.

    “The NIH EXAMINER provides a more comprehensive and in-depth measurement of executive functions than the Toolbox, however, including working memory measures that tap both verbal and spatial modalities and emphasize updating processes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductcitation

    The Conners 3-T Learning Problems subscale was moderately to highly correlated with the BASC-2 Learning Problems scale, indicating decent construct validity.

    “The Conners 3-T Learning Problems subscale (which contains 6 of the 9 items from the Conners 3-P) was moderately to highly correlated (r=.66-.92, p<.01) with the Learning Problems scale from the Behavior Assessment System for Children, Second Edition Teacher Report (BASC-2 TRS-C and BASC-2 TRS-A; Reynolds & Kamhaus 2004), indicating decent construct validity (Conners, 2008).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Reynolds & Kamhaus 2004

      Not checked in the free run.

    • cites Conners, 2008

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The WRAT-4 Word Reading and Woodcock-Johnson III Letter-Word Identification tests have good reliability and validity and are normed for young and older children.

    “Both of these tests of single word reading ability have good reliability and validity, are normed for both young and older children, and can be administered efficiently.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Wilkinson & Robertson, 2006

      Not checked in the free run.

    • cites Woodcock, McGraw, & Mather, 2001

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Theories increasingly highlight the role of executive function impairments in individuals with ADHD.

    “Theories increasingly highlight the role of executive function impairments in individuals with ADHD (Barkley, 1997; Berger & Posner, 2000; Castellanos & Tannock, 2002; Nigg, Willcutt, Doyle, & Sonuga-Barke, 2005; Pennington & Ozonoff, 1996).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Barkley, 1997

      Not checked in the free run.

    • cites Berger & Posner, 2000

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    • cites Castellanos & Tannock, 2002

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  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All participating sites administered tests using standardized instructions and procedures to minimize differences across settings.

    “All participating sites administered tests using standardized instructions and procedures to minimize differences across setting.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The existence of a core executive function deficit or an identifiable pattern of performance on tests in children with ADHD remains elusive.

    “Despite a large literature examining executive function in children with ADHD, the existence of a “core” executive function deficit or an identifiable pattern of performance on tests remains elusive (Doyle, 2006; Wodka et al., 2008).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Doyle, 2006

      Not checked in the free run.

    • cites Wodka et al., 2008

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  • May combine two claims.

    Study design and conductown data

    There was no significant difference between children with ADHD and controls in age or word reading ability.

    “There was not a significant difference in age, t(90)=−.52, p = .61, or in word reading ability, t(87)=−.83, p = .41).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    Age was used as a covariate in all analyses because the study included a broad age range and the EXAMINER executive function scores are not age-referenced.

    “Given that the study included a broad age range, and the executive function scores produced by the EXAMINER scoring program are not age-referenced, age was a covariate in all analyses.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The two-subtest form of the WASI provides a measure of Full Scale IQ that is highly correlated with the WISC-IV Full Scale IQ.

    “The two subtest form provides a measure of Full Scale IQ that is highly correlated with that derived from the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wechsler, 1999

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Prior work separates academic knowledge from school grades, the latter reflecting effort, behavior, homework, and knowledge.

    “When considering academic outcomes, the literature distinguishes between academic knowledge and school grades, which may combine effort, behavior, homework completion, and knowledge (Bowers 2011; Randall and Englehard 2009).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Bowers 2011

      Not checked in the free run.

    • cites Randall and Englehard 2009

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    The study selected children with relatively pure ADHD, excluding those with co-occurring learning or behavioral disorders.

    “Children were selected to have relatively “pure” ADHD, with no co-occurring learning or behavioral disorders.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Problems in concept definition and test development may have hampered hypothesis testing and replication of specific executive function deficits.

    “Problems in concept definition and test development may also have hampered hypothesis testing and replication of specific executive function deficits (Stefanatos & Baron, 2007).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stefanatos & Baron, 2007

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Earlier studies have shown that working memory predicts academic success.

    “which is consistent with prior research establishing working memory as a predictor of academic success (Alloway & Alloway, 2010; Alloway, et al., 2010; Gathercole, et al., 2004).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Alloway & Alloway, 2010

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    • cites Alloway, et al., 2010

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    • cites Gathercole, et al., 2004

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Clinical investigators are faced with several challenges, including the overwhelming number of tasks reputed to measure executive function.

    “Certainly, clinical investigators are faced with several challenges, including the overwhelming number of tasks reputed to measure executive function (Chiappe, Hasher, & Siegel, 2000).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Chiappe, Hasher, & Siegel, 2000

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Inhibitory deficits in ADHD are more frequent on tasks that require suppressing a prepotent motor response and less frequent on tasks that require suppressing a conflicting response.

    “Inhibitory deficits in children with ADHD more often occur on tasks requiring suppression of a prepotent motor response (e.g., basic go/no-go task) and are less common on tasks requiring suppression of a conflicting response (e.g., flanker test; Nigg, 2001).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Nigg, 2001

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Research on ADHD has particularly emphasized impairments in inhibitory control and working memory.

    “Research on ADHD has particularly emphasized impairments in inhibitory control (Barkley, 1997; Nigg, 2000) and working memory (Castellanos & Tannock, 2002; Martinussen, Hayden, Hogg-Johnson, & Tannock, 2005).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Barkley, 1997

      Not checked in the free run.

    • cites Nigg, 2000

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    • cites Castellanos & Tannock, 2002

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    A very small sample restricted examination of several potentially interesting variables.

    “First, the sample size was very small which limited our ability to examine certain variables that may be of interest.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The sample's wide age range, 8 to 16 years, covered key developmental stages.

    “Another limitation was the broad age range of the sample (ages 8–16 years), which spanned important developmental periods (i.e., middle childhood through adolescence).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Adjusting for IQ might remove the group difference because of shared variance.

    “and it is possible that covarying for IQ would eliminate the group difference due to shared variance.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Children with ADHD who lack comorbid learning or behavioral disorders might compensate more effectively for working memory weaknesses in school.

    “It is possible that children with ADHD and no comorbid learning or behavioral disorder may be better at compensating for working memory weaknesses when it comes to school performance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    ADHD children with IQ below 85 were excluded, yet the study could not determine whether group differences persisted after IQ adjustment.

    “Children with ADHD who had IQ scores below 85 were excluded, but we were unable to see if group differences remained after controlling for IQ.”
    Quote in the paperSubstantial claim
29 of 29

  • The paper relies on this without support.

    The sample of children with ADHD without comorbid disorders is representative of the broader population of children with ADHD without comorbid disorders.

    “Thirty-two children (24 male), ages 8–15 years (M=12.02, SD=2.29), diagnosed with ADHD and no comorbid disorder completed the NIH EXAMINER battery.”

  • The paper relies on this without support.

    The healthy control children selected from the multi-site database are comparable to the ADHD group on relevant characteristics other than age and gender.

    “Controls were selected to roughly match the ADHD participants with respect to age and gender. This ensured minimal group demographic differences; however, variable matching was not exact for all cases.”

  • The paper relies on this without support.

    Working memory behaviors such as holding and manipulating information are important for learning and acquiring knowledge.

    “Behaviors associated with working memory, such as holding information in mind and managing and manipulating multiple pieces of information simultaneously, are important for learning and acquiring knowledge.”

  • The paper relies on this without support.

    The NIH EXAMINER battery is a valid and reliable measure of executive function.

    “on a valid and reliable battery of executive function tests”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentt(90) = -0.52reported p = .61 · recomputed p = .604

    “t(90)=−.52, p = .61”

  • Consistentt(87) = -0.83reported p = .41 · recomputed p = .409

    “t(87)=−.83, p = .41”

  • ConsistentF(1, 30) = 1.738reported p = .197 · recomputed p = .197

    “F(1, 30)=1.738, p = .197”

  • ConsistentF(2, 29) = 1.103reported p = .345 · recomputed p = .345

    “F(2,29)=1.103, p = .345”

  • ConsistentF(3, 28) = 2.44reported p = .085 · recomputed p = .085

    “F(3,28)=2.440, p = .085”

  • ConsistentF(4, 27) = 5.41reported p = .002 · recomputed p = .002

    “F(4,27)=5.410, p = .002”

6 of 6

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

  • Recruitment counts leave two patients unaccounted for

    Minor

    The listed groups-33 who declined, 11 who aged out, four who missed testing, two who failed the rating-scale threshold, two who scored below the IQ threshold, and 32 enrolled-total 84, not the 86 families contacted. Two patients are unaccounted for.

    Reported 86 · recomputed 84

1 of 1

Cites

Flagged first, then by citations

1 of the 89 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. Woodcock, 2001, Woodcock-Johnson Third Edition, Tests of Achievement
  2. Wilkinson, 2006, Wide Range Achievement Test - 4 (WRAT-4)
  3. 2000, Diagnostic and statistical manual of mental disorders
  4. Reynolds, 2004, Behavior assessment for children, (BASC-2)

Cited by

Sorted by citations

Related

Authors
Schreiber, J. E., Possin, K. L., Girard, J. M., & Rey-Casserly, C.
Affiliations
  • St. Jude Children's Research Hospital (US)
  • University of California, San Francisco (US)
  • Boston Children's Hospital (US)
ORCID
Possin, Katherine L.
Venue
Journal of the International Neuropsychological Society
Publisher
Cambridge University Press (CUP)
Published
2013-10-08
Volume
20
Issue
1
Pages
41-51
ISSN
  • 1355-6177 (ISSN-L)
  • 1469-7661
DOI
10.1017/s1355617713001100
PMC
PMC4425416
OpenAlex
W2123396577
Semantic Scholar
086a5ce217753d25bb9181c805140ba5adb72c78
Cited by
68
References
89
Citations by year
2026: 5 · 2025: 7 · 2024: 10 · 2023: 10 · 2022: 2 · 2021: 10 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 8 · 2015: 1
FWCI
2.13
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Journal of the International Neuropsychological Society (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • University of Nebraska-Lincoln
  • National Institute on Aging (K23AG037566)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
attention deficit hyperactivity disorder, executive function, working memory, cognitive control, fluency, learning difficulties, academic difficulties, children, neuropsychological deficits
MeSH terms
Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Male, Memory, Short-Term, Neuropsychological Tests, Executive Function

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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