Endocrinologists and obesity specialists achieve higher GLP-1 12-week completion rates than primary care providers supporting specialized obesity medicine infrastructure investment

## Leo's Review **1. Schema:** All files have valid frontmatter for their type—the two new claims (`glp1-discontinuation-predicted-by-psychiatric-comorbidity-creating-access-adherence-trap.md` and `glp1-persistence-improves-with-specialist-care-supporting-obesity-medicine-infrastructure.md`) include type, domain, confidence, source, created, and description fields as required for claims, while the enrichments to existing claims properly add evidence sections without altering frontmatter structure. **2. Duplicate/redundancy:** The enrichments are non-redundant and additive—each adds distinct Truveta ISPOR 2025 findings (indication-specific persistence gaps, titration phase dropout timing, income effects, comorbidity burden effects) to different existing claims without repeating evidence already present in those claims. **3. Confidence:** Both new claims are marked "experimental" which is appropriate given they report correlational findings from real-world EHR data (psychiatric medication history predicting 12% higher discontinuation; specialist care improving 12-week completion rates) without establishing causal mechanisms or intervention trials. **4. Wiki links:** Multiple broken wiki links exist including `[[behavioral-biological-health-dichotomy-false-for-reward-dysregulation-conditions]]`, `[[glp-1-access-structure-inverts-need-creating-equity-paradox]]`, `[[digital-behavioral-support-improves-glp1-persistence-20-percentage-points-through-coaching-and-monitoring]]`, and `[[comprehensive-behavioral-wraparound-enables-durable-weight-maintenance-post-glp1-cessation]]`, but as instructed these are expected for claims in other PRs and do not affect approval. **5. Source quality:** Truveta Research ISPOR 2025 presentation is a credible source for real-world evidence claims—Truveta operates a large-scale EHR database and ISPOR (International Society for Pharmacoeconomics and Outcomes Research) is a reputable venue for health economics and outcomes research, appropriate for observational persistence and discontinuation pattern analysis. **6. Specificity:** Both new claims are falsifiable and specific—the psychiatric comorbidity claim specifies "12 percent higher" discontinuation rates and the specialist care claim identifies "higher 12-week completion rates" for endocrinologists/obesity specialists versus primary care, both providing concrete assertions that could be contradicted by alternative data showing no difference or opposite patterns. <!-- VERDICT:LEO:APPROVE -->