Audit: QRS - Acarbose for Health & Longevity

Audit conducted on 08/08/2026 09:29 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	91
Passed	81
Failed	0
N/A	10
Pass Rate	100.00%

• Total = Passed + Failed + N/A
• Pass Rate = Passed / (Passed + Failed) × 100
• N/A items are excluded from the pass rate calculation

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1. General Rules

#	Description	Result	Comments
1.1	Every claim, magnitude, label, recommendation, and statement in the QRS is literally supported by content in the source ER.	🟢	All protocol values, time-to-effect intervals, biomarker targets, cadence, contraindications and interactions trace verbatim or near-verbatim to the ER.
1.2	Where the ER uses cautious phrasing (“not formally studied”, “None documented in human trials to date”, “theoretical concern”, “data are limited”), the QRS uses the same phrasing.	🟢	No ER hedging phrase is dropped or replaced; the ER carries no empty-state phrasings to mirror.
1.3	The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”).	🟢	Contraindication severity (absolute vs “(relative)”) is carried through unchanged; no gate is softened or hardened.
1.4	The QRS does not relabel an ER fact under a different decision category. A “Benefit-Modifying Factor” from ER section is not surfaced as a “Caution”; a “Risk-Modifying Factor” is not surfaced as a “Side Effect”; etc.	🟢	Contraindications and interactions are drawn only from the ER Key Interactions & Contraindications section; no modifying factor is surfaced as a gate or side effect.
1.5	PubMed IDs, study citations, expert names, clinical trial identifiers (NCT*), and brand names appear in the QRS only if they appear in the source ER for the same fact.	🟢	No PMIDs, NCT identifiers, study names or expert names appear. The only brand name, “Beano”, appears in the ER for the same fact.
1.6	The QRS does not introduce new attributions.	🟢	No attributions of any kind appear in the QRS.

2. Focus, Tone & Audience

#	Description	Result	Comments
2.1	The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing.	🟢	Measured, evidence-weighted register matching the ER throughout.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Expert and data-driven (dose thresholds, biomarker ranges) while remaining readable.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Presents thresholds and observations without instructing.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperatives or clinical directives; protocol cells describe dosing patterns rather than prescribing them.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	Content is stated as fact; no “recommended”, “advised” or “should”.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the document.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms are limited to unavoidable drug and biomarker names.
2.8	Information is presented in a concise and very compact manner	🟢	Every list item is a single condensed clause; no prose paragraphs outside the At-A-Glance block.
2.9	It DOES NOT address the reader directly	🟢	No direct address to the reader.
2.10	The target audience is health- and longevity-oriented adults who are risk-aware, proactive, and actively seeking to optimize health or apply the intervention under review.	🟢	Framing assumes an adult actively measuring post-meal glucose and considering off-label longevity use.
2.11	The target audience is willing to employ lifestyle and behavioral changes as well as follow protocols that may be inconvenient, costly, or require effort.	🟢	Presents a three-times-daily meal-matched regimen, multi-year titration and a 12-marker monitoring panel without softening the burden.
2.12	The document is NOT written for the general population, who are unwilling to employ lifestyle and behavioral changes or follow protocols that may be inconvenient, costly, or require effort.	🟢	The GI burden, discontinuation rate and monitoring demands are presented plainly rather than downplayed for a general readership.
2.13	Framing, takeaways, and risk/benefit weighting throughout the document reflect this audience, including where an intervention’s signal for the average person differs from its signal for this audience.	🟢	At-A-Glance explicitly separates the strong glycemic signal from the untested human longevity signal, the distinction that matters for this audience.
2.14	The document’s own voice frames usage in longevity terms, not “anti-aging” (e.g., “anti-aging clinics”, “anti-aging community”, “anti-aging medicine”). Proper names that contain “anti-aging” (e.g., “American Academy of Anti-Aging Medicine”) are quoted verbatim.	🟢	The term “anti-aging” does not appear; longevity framing is used throughout.
2.15	The document’s own voice uses formal clinical and scientific terminology, not colloquial or consumer-grade language (e.g., “oral medication” not “pill(s)”; “injection” not “shot”; “adverse event” not “bad reaction”). Direct quotes from sources are exempt.	🟢	Uses “oral medication”, “flatulence”, “loose stools”, “transaminases”; plain-language wording in At-A-Glance mirrors the ER Conclusion verbatim in register.

3. Template Integrity

#	Description	Result	Comments
3.1	The following labels and headings on the QRS are fixed and not modified: Card and section headings: “Protocol”, “Time to effect”, “Benefits”, “Risk & Side Effects”, “Monitoring”, “Qualitative Assessment”; Gate headings: “Contraindications”, “Key Interactions”; Tier labels: “High”, “Medium”, “Low”, “Speculative”; Table column headers in Monitoring: “Marker”, “Target”, “Why”	🟢	All fixed headings, gate headings, tier labels and table column headers match the template exactly.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 34 template variables are present; the repeatable marker_#* and qualitative_item# spans are instantiated 12 and 7 times respectively.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	A normalized diff of all non-variable content against [qrs_template] is identical apart from the repeated marker rows and qualitative list items.

4. Formatting

#	Description	Result	Comments
4.1	When the source ER section is empty, the QRS uses the ER’s own empty-state phrasing verbatim. Typical phrasings are “None documented in human trials to date” and “Not formally studied”	N/A	No section of the source ER is empty, so no empty-state phrasing is required.
4.2	Where the ER presents a bulleted item as “Label: content”, the QRS uses the ER’s bold label verbatim as the cell or row label.	🟢	Protocol cell labels reproduce the ER bold labels verbatim (“Standard clinical titration”, “Conservative longevity-oriented titration”, “Event-based or intermittent dosing”).
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Marker names reproduce the ER biomarker table column verbatim; time-to-effect labels use the ER’s own wording.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji characters occur anywhere in the file.
4.5	The QRS is designed to render on one A4 page. Any section that has more content in the ER than fits the per-section budget is condensed by the LLM, not extended onto a second page.	🟢	Every section is condensed to a single clause per item rather than carrying ER prose; the template’s two-column gate layout and compact type scale are used unchanged.

5. Metadata

#	Description	Result	Comments
5.1	The metadata is placed inside a single HTML comment that is the first element after “<!doctype html>” and before any other comment, head, or body content.	🟢	The metadata comment at lines 2-14 is the first element after “<!doctype html>”.
5.2	Inside that HTML comment the YAML block is delimited by a line “—” opening and a line “—” closing. Text before the opening “—” is permitted but is not parsed as YAML.	🟢	YAML opens at line 3 and closes at line 13; the preceding title text sits outside the delimiters.
5.3	The metadata is not visible in any rendered view of the QRS and is not surfaced by any other element on the sheet.	🟢	Enclosed in an HTML comment and not echoed by any visible element.
5.4	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	All values trimmed; only “00:03” is quoted, which is required because it contains a colon.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	“er_filename: acarbose_2026-0808-0620_Opus_ER.md” matches the source ER.
5.6	Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]”	🟢	“qrs_prompt_version: 26.7.02” matches the QRS.md version badge.
5.7	Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430)	🟢	“qrs_creation_date: 2026-0808-0846” is correctly formatted.
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢	“qrs_creator_ai_nickname: Opus”.
5.9	The nickname of the AI is just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT)	🟢	Single word, no version or qualifier.
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢	“qrs_creator_ai_fullname: Opus 5”.
5.11	The full name of the AI consists of the [qrs_creator_ai_nickname] and the model version number and no additional qualifier (e.g., Opus 4.6, Sonnet 3.2, Grok 4.5, Gemini 3.1, ChatGPT 5.4)	🟢	Nickname plus version number only, no additional qualifier.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	“qrs_filename: acarbose_2026-0808-0620_Opus_QRS.html” matches the file on disk.
5.13	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	No stray whitespace or unnecessary quoting in any value.

6. Page Title & Header

#	Description	Result	Comments
6.1	[page_title] is set to the [canonical_topic] of the ER frontmatter followed by “ - Quick Reference Sheet” (e.g., “Intervention - Quick Reference Sheet”). The [canonical_topic] is HTML-entity-encoded as needed (e.g., & for &)	🟢	“Acarbose for Health & Longevity - Quick Reference Sheet” with the ampersand entity-encoded.
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	“Acarbose for Health & Longevity” matches the ER canonical_topic.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	“08/08/2026” derived from qrs_creation_date 2026-0808-0846.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	“Opus 5” matches qrs_creator_ai_fullname.
6.5	No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker.	🟢	Header carries only title, date, source-review link and model name; no AKA line despite the ER having alternate_names.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Condenses the ER Conclusion into mechanism, what human evidence supports, what it does not, the untested longevity claim and the dominant side effect.
7.2	[at_a_glance] is no longer than 60 words	🟢	Exactly 60 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Each clause maps to a distinct sentence of the ER Conclusion (lines 549-553).
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; “blood sugar” and “table sugar” are used in place of glycemic terminology.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial names, years or sample sizes.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No hazard ratios, percentages or confidence intervals.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	Drawn from the “Populations who should avoid acarbose” bullet of that ER section.
8.2	[stop_items] represent the Contraindications from the ER	🟢	All eight absolute and all seven relative barriers from the ER are represented across the 13 items.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Each item is a discrete <li> inside the [stop_items] span.
8.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	Each item is a bare clause; no trailing dash clauses, rationale or citations.
8.5	Parenthetical qualifiers from the ER bullet — time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	Thresholds and severity markers are retained: “above 2.0 mg/dL”, “below 25-30 mL/min/1.73 m2”, “twice upper limit of normal”, “below 60 kg at doses above 50 mg three times daily”, and “(relative)” on every relative barrier.
8.6	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	The ER Key Interactions & Contraindications section uses no ranking notation (“>” or similar) inside parentheses.
8.7	If no [stop_items] are present the section is left empty	N/A	[stop_items] are present (13 items), so the empty-section condition does not apply.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	Drawn from the twelve interaction bullets of that ER section.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	All twelve ER interaction bullets are represented; none duplicates a contraindication.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Each item is a discrete <li> inside the [caution_items] span.
9.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	Severity, consequence and mitigation prose from the ER bullets is stripped; only the interacting agent remains.
9.5	Parenthetical qualifiers from the ER bullet — example drug lists, time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	Example drug lists are retained in parentheses for each class and trimmed only where the one-page budget requires.
9.6	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	The ER Key Interactions & Contraindications section uses no ranking notation (“>” or similar) inside parentheses.
9.7	If no [caution_items] are present the section is left empty	N/A	[caution_items] are present (12 items), so the empty-section condition does not apply.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	Derived from the ER Therapeutic Protocol section.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Standard clinical titration, conservative longevity-oriented titration and event-based/intermittent dosing are the three actionable dosing patterns in that section.
10.3	If less that three distinct actionable implementation aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	Three distinct actionable implementation aspects are present in the ER Therapeutic Protocol section, so all three action sets are used.
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section.	🟢	All nine action fields carry substantive content traceable to the ER protocol bullets.

11. Time to Effect

#	Description	Result	Comments
11.1	The three sets of [time] items cover the three most important time-to-effect aspects from the ER	🟢	Glycemic effect, hemoglobin A1c and lipid/inflammatory markers are the three time-to-effect aspects in the ER Practical Considerations bullet.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Ordered immediate glycemic effect (High-tier benefit), hemoglobin A1c (High-tier), then lipid and inflammatory markers (Medium-tier).
11.3	If less that three distinct time-to-effect aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	Three distinct time-to-effect aspects are present in the ER, so all three time sets are used.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢	All nine time fields carry content traceable to the ER (“immediate”, “8-12 weeks”, “12-24 weeks”).
11.5	If the ER does not provide any information on time to effect, the section is removed completely from the Protocol Panel	N/A	The ER provides time-to-effect information (Practical Considerations, “Time to effect”), so the section is retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	Derived from the ER Expected Benefits section.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four tier variables are present and populated.
12.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢	Each benefit is reduced to its ER subsection heading with no magnitude, mechanism or caveat.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parenthetical content appears in any benefits item.
12.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	N/A	All four benefit tiers are populated from the ER Expected Benefits section.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	Derived from the ER Potential Risks & Side Effects section.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four tier variables are present and populated.
13.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢	Each risk is reduced to its ER subsection heading; no incidence figures or mechanisms are carried over.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parenthetical content appears in any risks item.
13.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	N/A	All four risk tiers are populated from the ER Potential Risks & Side Effects section.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Derived from the ER Monitoring Protocol & Defining Success section.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All 12 biomarkers from the ER table are present with matching optimal ranges.
14.3	[monitoring_cadence] is populated with the monitoring cadence/frequency derived from the ER Monitoring section. It is not left with placeholder text or empty.	🟢	Populated with the full ER cadence, including liver enzymes, glycemic panel, ferritin/CBC, CGM periods and weight/grip strength.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	Derived from the qualitative marker list in the ER Monitoring Protocol & Defining Success section.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All seven ER qualitative markers are listed.

Issues 08/08/2026 09:29

Pass rate 100.00%. No issues found.

Issues 08/08/2026 09:19

1. 4.5 — QRS overruns one A4 page: The rendered sheet substantially exceeds the ~1030 px usable print height of one A4 page; the decision-gate block alone consumes roughly half a page because caution_items (lines 596–616) wraps to ~26 lines and stop_items (lines 576–590) to ~18, while the three action_#_sub cells (lines 456–487) each wrap to four lines and several Monitoring “Why” cells (lines 687, 763, 801) wrap to two.

Fixes 08/08/2026 09:19

1. 4.5 — Key Interactions condensed: Reduced the tallest gate column from ~26 to ~18 wrapped lines by trimming labels and example drug lists (e.g. “Over-the-counter medications that raise blood glucose (high-dose niacin, pseudoephedrine, phenylephrine, corticosteroids)” → “Glucose-raising non-prescription drugs (niacin, pseudoephedrine, phenylephrine, corticosteroids)”); every named class and at least one example drug per class is retained.
2. 4.5 — Contraindications condensed: Shortened five stop_items without dropping any item or threshold, e.g. “Any condition worsened by increased intestinal gas, e.g. large abdominal hernia” → “Conditions worsened by intestinal gas (large hernia)” and “Gastroparesis or prior extensive bowel resection (relative)” → “Gastroparesis, prior bowel resection (relative)”.
3. 4.5 — Protocol sub-cells shortened: Cut action_1_sub, action_2_sub and action_3_sub from four wrapped lines each to two, e.g. “With the first bite of each main meal; raised at four-to-eight-week intervals to 50 mg, and only where clearly needed to 100 mg.” → “First bite of each main meal; raised every 4–8 weeks to 50 mg, then 100 mg only where clearly needed.”
4. 4.5 — Time-to-effect sub-cells shortened: Trimmed time_1_sub, time_2_sub and time_3_sub to a single clause each, e.g. “The point at which these were measured in most trials.” → “When these were measured in most trials.”
5. 4.5 — Monitoring “Why” cells reflowed to one line: Shortened marker_2_why, marker_8_why, marker_11_why and marker_12_why, e.g. “Sets the safety ceiling, since the absorbed fraction is cleared by the kidneys” → “Sets the safety ceiling; absorbed fraction is renally cleared”.
6. 4.5 — Cadence and qualitative wording tightened: Replaced “body weight” with “weight” in monitoring_cadence and “distinguishing” with “separating” in qualitative_item_4, keeping all 12 markers and all 7 qualitative items intact per items 14.2 and 15.2.

Issues 08/08/2026 09:10

1. 4.2 / 4.3 — Key Interactions labels paraphrased: Six of the twelve caution_items rewrite the ER’s bold bullet label instead of reusing it verbatim — “Over-the-counter medications that raise blood glucose” became “Glucose-raising agents” (line 604), “Over-the-counter simethicone and alpha-galactosidase products” became “Simethicone; alpha-galactosidase” (line 606), “Supplements with additive glucose-lowering effects” became “Glucose-lowering supplements” (line 607), “Supplements with directly overlapping mechanisms” became “Overlapping-mechanism supplements” (line 609), “Fermentable fiber supplements” became “Fermentable fiber” (line 611) and “Interaction with other longevity interventions” became “Other longevity interventions” (line 612).
2. 4.3 — Enzyme product name abbreviated: The ER’s “amylase-containing products” is abbreviated to “amylase products” in the digestive enzyme preparations item (line 600).

Fixes 08/08/2026 09:10

1. 4.2 / 4.3 — Key Interactions labels restored verbatim: Six paraphrased caution_items labels were replaced with the ER’s bold bullet labels — “Glucose-raising agents” → “Over-the-counter medications that raise blood glucose”, “Simethicone; alpha-galactosidase” → “Over-the-counter simethicone and alpha-galactosidase products”, “Glucose-lowering supplements” → “Supplements with additive glucose-lowering effects”, “Overlapping-mechanism supplements” → “Supplements with directly overlapping mechanisms”, “Fermentable fiber” → “Fermentable fiber supplements”, and “Other longevity interventions” → “Interaction with other longevity interventions”.
2. 4.3 — Enzyme product name unabbreviated: In the digestive enzyme preparations item, “amylase products” was restored to the ER’s “amylase-containing products”.

Issues 08/08/2026 09:04

1. 8.5 — Dose qualifier garbled in weight contraindication: The relative-barrier item at line 587, “Body weight below 60 kg above 50 mg three times daily (relative)”, drops the ER’s “at doses” (ER line 395), leaving the dose threshold grammatically detached and ambiguous.
2. 9.5 — Drug-class names truncated: The interaction item at line 598 renders the ER’s classes as “DPP-4, SGLT2” where ER line 373 reads “DPP-4 inhibitors” and “SGLT2 inhibitors”; without the head noun the parenthetical no longer names a drug class.

Fixes 08/08/2026 09:04

1. 8.5 — Dose qualifier restored: Changed the weight contraindication from “Body weight below 60 kg above 50 mg three times daily (relative)” to “Body weight below 60 kg at doses above 50 mg three times daily (relative)”, matching the ER wording.
2. 9.5 — Drug-class names completed: Changed the interaction parenthetical from “metformin, DPP-4, SGLT2, GLP-1 receptor agonists” to “metformin, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists”.

Issues 08/08/2026 08:53

1. 4.5 — Sheet exceeds one A4 page: At the A4 print content width of 703 px the sheet totals roughly 2.4 pages against a 1032 px budget; the contraindications gate wraps to 19 lines, the interactions gate to 26, and no section was condensed to its per-section budget.
2. 1.3 / 8.5 — Relative barriers shown as absolute: ER line 395 separates eight “Absolute contraindications per the labeling” from “Relative barriers” and notes that serum creatinine above 2.0 mg/dL is placed “under precautions as not recommended rather than among the absolute contraindications”, but QRS lines 579–594 list all thirteen items flat under “Contraindications” with the severity class dropped.
3. 8.5 — eGFR threshold parenthetical dropped: The ER’s “(approximately estimated glomerular filtration rate below 25–30 mL/min/1.73 m²)” qualifier on the creatinine threshold is dropped entirely at QRS line 589 rather than trimmed.
4. 2.8 — Gate and protocol items not compacted: Items such as “Any condition that would deteriorate with increased intestinal gas formation, such as a large abdominal hernia” (QRS lines 585–586) and the 33-word action_1_sub (lines 456–460) are carried over near-verbatim from the ER instead of being presented in the compact form the format requires.

Fixes 08/08/2026 08:53

1. 1.3 — Relative barriers no longer shown as absolute: Appended “(relative)” to the five [stop_items] that ER line 395 lists as relative barriers (creatinine, transaminases, body weight, pregnancy/breastfeeding/age under 18, gastroparesis/bowel resection), so the ER’s severity class is preserved; prior pneumatosis cystoides intestinalis was left unmarked because ER line 364 calls it an absolute barrier to re-exposure.
2. 8.5 — eGFR threshold restored: The creatinine item now reads “Serum creatinine above 2.0 mg/dL, eGFR below 25–30 mL/min/1.73 m² (relative)”, restoring the threshold qualifier that had been dropped from ER line 395.
3. 4.5 / 2.8 — Decision gates condensed: Shortened contraindication and interaction wording while keeping all 13 and 12 items and their example lists — e.g. “Chronic intestinal disease with marked disorders of digestion or absorption” to “Chronic malabsorptive intestinal disease”, and “Over-the-counter medications that raise blood glucose (…)” to “Glucose-raising agents (…)”, cutting the interactions gate from 26 to 21 wrapped lines.
4. 4.5 / 2.8 — Protocol, cadence and qualitative text condensed: Trimmed the three action_#_sub cells (action_1_sub from 33 to 22 words), the monitoring cadence paragraph from 62 to 48 words, and qualitative item 4, without dropping any ER-sourced fact.