“The evidence is mixed” is a finding. It should not be a dead end.
Referrers want a rationale in writing. Patients want a straight answer. Titrate keeps the supporting and the contradicting work side by side, so what you send is a position with its sources attached.
Titrate is pre-launch. What is described here is what it is being built to do, with Jeff Casebolt, PhD.
The central question
Does passing objective return-to-sport (RTS) criteria/test batteries (strength symmetry limb-symmetry indices, hop tests, time-based thresholds, etc.) before returning to sport reduce an athlete's risk of a second ACL injury (graft rupture or contralateral tear)?
- Grindem et al.2016n=106supports
- Kyritsis et al.2016n=158supports
- Webster et al.2019n=—mixed
- Losciale et al.2019n=4 studies po…contradicts
- Zhou et al.2024n=9 studiesmixed
- Paterno et al.2022n=159contradicts
A workbench, not a chatbot.
Nothing here writes a confident paragraph for you to trust. There is no chat window. You keep the judgment; the tool keeps the trail back to the papers. It cannot hallucinate a citation because it does not generate citations at all — a claim points at a paper already sitting in your own library, or it points at nothing.
The evidence really is mixed — and every tool flattens it anyway.
Ask a general AI tool about return-to-sport criteria and you get one confident paragraph. You cannot hand that to a referring physician, because you cannot show where it came from or what it left out. So you write the rationale again, from scratch, for the fourth time this month.
A real topic stack
The question you get asked every week, with the literature that disagrees about it.
A stack is not a folder. It is a question, with everything you have read that bears on it assembled underneath — carrying what a clinician actually judges a paper by: the design, the sample, and which way it cuts.
The central question
Does passing objective return-to-sport criteria before returning to sport reduce an athlete's risk of a second ACL injury?
| Paper | Year | Design | N | Bears on the question |
|---|---|---|---|---|
| Grindem et al. | 2016 | Prospective cohort | 106 | supports |
| Kyritsis et al. | 2016 | Prospective cohort | 158 | supports |
| Webster & Hewett | 2019 | Systematic review / meta-analysis | — | mixed |
| Losciale et al. | 2019 | Systematic review / meta-analysis | 4 studies | contradicts |
| Paterno et al. | 2022 | Prospective case-cohort | 159 | contradicts |
| Zhou et al. | 2024 | Systematic review / meta-analysis | 9 studies / 1,410 | mixed |
2 supporting · 2 contradicting · 2 mixed
What the stack shows that a paragraph cannot
The two cohort studies everyone cites in clinic found large protective associations. The independent meta-analyses that pooled across cohorts mostly did not — and the most recent of them separates the outcomes, finding no association with second ACL injury overall but a real one for graft rupture specifically. Which paper you were handed decides what you believe, and that is exactly the thing a single confident paragraph hides from you.
Nothing here collapses those six rows into a recommendation. What you send a referrer is your position, with these papers attached to it — including the two that cut against you.
Every paper listed here is real and independently re-verified on 2 August 2026 against PubMed, PMC, the DOI resolver, Unpaywall and an open citation-graph API. The screen is not. Titrate is pre-launch, and the topic-stack view is designed, not built — this is the specification, shown with real material rather than mocked up. Labelling how a paper bears on the question is a design commitment, not a shipped feature, and it is not what makes Titrate different.
What Titrate does about it
Start from the papers you have, or from the question itself — Topic Finder proposes, you decide which candidates survive. Keep the trial, the systematic review and the dissenting cohort study in the same topic. Write the position once, with each claim carrying the paper it came from. Send that — and reuse it the next time the same question arrives.
What a Titrate workspace holdsMixed evidence stays mixed.
Supporting and contradicting work is kept where you can see both. Titrate is being built so a position never quietly resolves a disagreement the literature has not resolved.
How evidence is handledTitrate is being built with Jeff Casebolt, PhD — a biomechanist with five peer-reviewed publications, who has been through peer review himself.
About Jeff and why this existsQuestions
Is that stack included, or do I have to build my own?
You build your own. The stack above is a specimen — assembled from published literature to show the shape of the thing, not shipped as content you subscribe to. Titrate can help you find candidates on a topic; what it will not do is curate a reading list or tell you which papers matter. It proposes, you dispose. If it decided for you, you would be reading someone else's review again, which is the exact position this is meant to get you out of.
How is this different from asking an AI research tool?
Those tools answer a question. Titrate helps you hold a position. The output is yours, it carries your reasoning, and every claim in it points at the paper underneath.
Can I use this for patient-facing education?
That is the intended use: write the position once, with sources, and reuse it. Titrate is pre-launch, so today this describes what it is being built to do.
I pay for a research review specifically because there is no AI in it. Why would I use software?
That is a reasonable position and it is close to the one this is built on. Nothing in Titrate reads a paper for you, summarises it for you, or writes your position. There is no chat window and no generated paragraph anywhere in it — the judgment is human, it is just yours instead of an editorial team's. What the software does is the clerical half: hold the papers, keep a question attached to them, and keep every claim's citation on the record itself rather than in a second app you have to remember to update.
Does this get me access to papers I cannot read?
No. Titrate has no journal access to give you and does not pretend otherwise — if a paper is behind a paywall it is still behind a paywall, and no product in this category redistributes paywalled full text. It is worth knowing the size of that. On the return-to-sport question this page uses as its example, PubMed indexes 269 papers: 97 are free to read somewhere and 36 sit in the redistributable open-access subset (retrieved 2 August 2026 — re-run it). So roughly two-thirds of that literature can only ever reach you as a citation. What Titrate holds is the record: the citation, what you were able to read, and where it sits against the question. A citation-only record with the fields you could not retrieve marked unknown is a legitimate entry, not a broken one.
Titrate is pre-launch.
Join the practitioner waitlistOne email when the first practitioner cohort opens. Nothing else.
