{
  "id": "SCR-LIP-000361",
  "statement": "The first Dutch lipedema guidelines define clinical diagnostic criteria requiring all five Wold anamnestic criteria (disproportionate fat distribution, poor fat response to weight loss, pain/easy bruising, touch sensitivity/extremity fatigue, no pain reduction with elevation) plus at least one regional physical-examination criterion pair, with extra criteria (bimanual palpation pain, distal-knee lipomas) compensating when up to two criteria are absent, while noting the absence of objective diagnostic criteria.",
  "statement_pt": "As primeiras diretrizes holandesas sobre lipedema definem critérios diagnósticos clínicos exigindo os cinco critérios anamnéticos de Wold (distribuição desproporcional de gordura, pouca resposta à perda de peso, dor/equimoses fáceis, sensibilidade ao toque/fadiga das extremidades, ausência de redução da dor com elevação) mais pelo menos um par de critérios de exame físico por região, com critérios extras (dor à palpação bimanual, lipomas distais ao joelho) compensando a ausência de até dois critérios, ressaltando a falta de critérios diagnósticos objetivos.",
  "claim_type": "clinical_association",
  "context": {
    "population": "—",
    "condition": "lipedema",
    "exposure": "—",
    "comparator": "—",
    "outcome": "—",
    "scope": "auto-ingested from Layer 1 surveillance"
  },
  "knowledge_state": "emerging",
  "evidence_confidence": "moderate",
  "evidence": [
    {
      "ref": "DOI:10.1177/0268355516639421",
      "stance": "supporting",
      "study_design": "review",
      "n": null,
      "risk_of_bias": "unknown",
      "grade": "moderate",
      "year": 2017,
      "amato_authored": false,
      "note": "The article is a national guideline proposing explicit clinical diagnostic criteria (Wold criteria plus physical-exam criteria) and a clinimetric data set for lipedema, directly addressing the diagnostic criteria portion of the question; it"
    }
  ],
  "relations": [],
  "gaps": "Auto-ingested single source; not yet human-reviewed.",
  "primary_amato_source": null,
  "curators": [],
  "provenance": {
    "auto": true,
    "engine": "anthropic/claude-opus-4.8",
    "question": "SQ-LIP-000022",
    "source": "library",
    "ingested": "2026-05-31"
  },
  "created": "2026-05-31",
  "updated": "2026-05-31",
  "history": [
    {
      "date": "2026-05-31",
      "event": "created",
      "detail": "auto-ingested for SQ-LIP-000022"
    }
  ],
  "license": "CC-BY-4.0",
  "answers_questions": [
    {
      "id": "SQ-LIP-000022",
      "role": "supporting",
      "question": "What clinical criteria and stage/type classification systems are used to diagnose and grade lipedema, and how reliable are they?",
      "url": "https://scientificclaims.org/q/SQ-LIP-000022.html"
    }
  ],
  "url": "https://scientificclaims.org/c/SCR-LIP-000361.html"
}