{
  "id": "SCR-LIP-000373",
  "statement": "The German S1 guideline defines lipedema diagnostic criteria (onset at puberty/pregnancy/menopause, disproportional adipose proliferation sparing hands and feet, periarticular cuffing, palpation hypersensitivity, increasing edema, negative Stemmer sign) and classifies it by three morphological stages and by anatomical location, with differential criteria distinguishing it from lipohypertrophy, obesity, and lymphedema.",
  "statement_pt": "A diretriz alemã S1 define critérios diagnósticos do lipedema (início na puberdade/gestação/menopausa, proliferação adiposa desproporcional poupando mãos e pés, cuffing periarticular, hipersensibilidade à palpação, edema crescente, sinal de Stemmer negativo) e o classifica por três estágios morfológicos e por localização anatômica, com critérios diferenciais que o distinguem de lipohipertrofia, obesidade e linfedema.",
  "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:10.1111/ddg.13036",
      "stance": "supporting",
      "study_design": "review",
      "n": null,
      "risk_of_bias": "unknown",
      "grade": "moderate",
      "year": 2017,
      "amato_authored": false,
      "note": "This consensus-based guideline directly specifies the clinical diagnostic criteria and stage/location classification systems for lipedema, but it is an S1 (lowest evidence-level) guideline based on expert consensus and notes diagnostic unce"
    }
  ],
  "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-000373.html"
}