Audit: QRS - Alirocumab for Health & Longevity
Audit conducted on 29/09/2026 05:21 using AI4L / Opus 5.5
Summary
| Items | Count |
|---|---|
| Total | 94 |
| Passed | 84 |
| 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
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, time-to-effect, tier, gate, marker, and cadence content traced to ER (Therapeutic Protocol, Practical Considerations, Expected Benefits, Potential Risks, Key Interactions, Monitoring) |
| 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. | 🟢 | Cautious wording kept, e.g., “possibly fewer deaths”, “(not studied)”, “unless under specialist oversight”, “Avoid outside trials” |
| 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”). | 🟢 | No strengthening or softening found; pregnancy item keeps “especially in the second and third trimesters” |
| 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 come from “Populations who should avoid”; interactions from interaction bullets; modifying factors not surfaced |
| 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. | 🟢 | Only brand name is Praluent (ER line 30/37); no PMIDs, NCTs, or experts in QRS |
| 1.6 | The QRS does not introduce new attributions. | 🟢 | No attributions present |
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. | 🟢 | |
| 2.2 | The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging | 🟢 | |
| 2.3 | The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor | 🟢 | |
| 2.4 | The QRS avoids language that implies medical or clinical advice | 🟢 | |
| 2.5 | The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” | 🟢 | |
| 2.6 | The QRS never addresses “the reader” directly — it presents evidence, not guidance | 🟢 | No direct address found |
| 2.7 | The QRS is written in plain language, avoiding unnecessary medical jargon | 🟢 | Technical terms limited to lab-marker names and ER threshold qualifiers; “Subcutaneous injection (under the skin)” glossed |
| 2.8 | Information is presented in a concise and very compact manner | 🟢 | |
| 2.9 | It DOES NOT address the reader directly | 🟢 | No “you”/”your” in the QRS |
| 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. | 🟢 | |
| 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. | 🟢 | |
| 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. | 🟢 | |
| 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. | 🟢 | Monitoring targets reflect optimal functional ranges, e.g., apoB “40–50 mg/dL for aggressive longevity targets” |
| 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. | 🟢 | No “anti-aging” wording |
| 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)”; “oral” / “administered orally” not “taken by mouth” / “given by mouth”; “injection” not “shot”; “adverse event” not “bad reaction”). This holds on EVERY surface, including the QRS lede — the stricter plain-language bar (see 2.7) does not license lay phrasing for route of administration. Direct quotes from sources are exempt. | 🟢 | Lede uses “prescription antibody medication, administered by injection”; no pill/shot/by-mouth wording |
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 column headers match the template |
| 3.2 | All “…” from the [qrs_template] are present in the the QRS. | 🟢 | All 38 template variable spans present (marker/qualitative spans expanded per row) |
| 3.3 | Spans that are not addressed in a checklist item are left unchanged | 🟢 | website spans and fixed markup unchanged versus template |
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 source ER section used by the QRS is empty |
| 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 labels and interaction labels match ER bold labels verbatim |
| 4.3 | Labels are not paraphrased, abbreviated, or invented. | 🟢 | |
| 4.4 | The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. | 🟢 | No emoji found |
| 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. | 🟢 | Sections condensed (interactions without effect omitted, rationales stripped); remaining length driven by required verbatim labels and full biomarker list |
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. | 🟢 | |
| 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. | 🟢 | |
| 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. | 🟢 | |
| 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. | 🟢 | duration quoted because value contains a colon |
| 5.5 | The filename of the source ER is stated as “er_filename: [er_filename]” | 🟢 | |
| 5.6 | Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]” | 🟢 | 26.9.28 matches QRS.md version |
| 5.7 | Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430) | 🟢 | 2026-0929-0504 |
| 5.8 | The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]” | 🟢 | |
| 5.9 | The nickname of the AI is just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT) | 🟢 | |
| 5.10 | The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]” | 🟢 | |
| 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) | 🟢 | |
| 5.12 | The filename of the document is stated as “qrs_filename: [filename of this document]” | 🟢 | |
| 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. | 🟢 |
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 &) |
🟢 | |
| 6.2 | [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &) |
🟢 | |
| 6.3 | [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] | 🟢 | 09/29/2026 from 2026-0929-0504 |
| 6.4 | [header_subline_model] is set to [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. | 🟢 |
7. At-A-Glance Section
| # | Description | Result | Comments |
|---|---|---|---|
| 7.1 | [at_a_glance] opens by saying what the intervention is — its kind (e.g., dietary supplement, prescription medication, peptide, plant, procedure, practice) — and what it is used for, in plain language, before any verdict on the evidence | 🟢 | Opens “Alirocumab (Praluent) is a prescription antibody medication … used to lower the cholesterol-carrying particles that clog arteries” |
| 7.2 | [at_a_glance] is dense, execution-oriented summary of the ER Conclusion section |
🟢 | Mirrors ER Conclusion paragraphs 1–2 |
| 7.3 | [at_a_glance] is no longer than 70 words | 🟢 | 64 words |
| 7.4 | Every fact in [at_a_glance] is supported by a distinct passage in the ER. | 🟢 | |
| 7.5 | It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead | 🟢 | |
| 7.6 | It DOES NOT cite specific trials (names, years, sample sizes, p-values) | 🟢 | |
| 7.7 | It DOES NOT cite effect sizes, relative risks, or statistical results | 🟢 |
8. Contraindications
| # | Description | Result | Comments |
|---|---|---|---|
| 8.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | |
| 8.2 | [stop_items] represent the Contraindications from the ER | 🟢 | All four ER “Populations who should avoid” items represented |
| 8.3 | Individual [stop_items] are formatted as <li></li> | 🟢 | |
| 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. | 🟢 | Rationales (“because no data exist”, “when antibody transfer … increases”) stripped |
| 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 (eGFR below 30, Child-Pugh Class C, younger than 8 years, trimesters) preserved |
| 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 | ER uses no ranking notation in contraindications |
| 8.7 | The section is left empty ONLY IF the ER’s Key Interactions & Contraindications section identifies no population, condition, or scenario for which the intervention should be avoided, deferred, or used only under specialist supervision. |
🟢 | Section populated; ER names four populations |
| 8.8 | If the section is left empty, an HTML comment inside the [stop_items] span records the ER basis for the absence, naming or quoting the ER text relied on. E.g. | N/A | Section is not empty |
9. Key Interactions
| # | Description | Result | Comments |
|---|---|---|---|
| 9.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | |
| 9.2 | [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications | 🟢 | All ER interactions with a Monitor/Caution/Avoid rating listed; “None known”/”Compatible” entries omitted; no overlap with contraindications |
| 9.3 | Individual [caution_items] are formatted as <li></li> | 🟢 | |
| 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. | 🟢 | Items reduced to label and ER severity term; injectables item keeps only the same-site restriction |
| 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 preserved verbatim |
| 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 | ER uses no ranking notation in interactions |
| 9.7 | The section is left empty ONLY IF the ER’s Key Interactions & Contraindications section identifies no interaction, additive effect, or exposure that changes how the intervention is used. |
🟢 | Section populated; ER names several interactions |
| 9.8 | If the section is left empty, an HTML comment inside the [caution_items] span records the ER basis for the absence, naming or quoting the ER text relied on. E.g. | N/A | Section is not empty |
10. Protocol
| # | Description | Result | Comments |
|---|---|---|---|
| 10.1 | The section is derived from the ER Protocol section |
🟢 | |
| 10.2 | The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section |
🟢 | Standard label regimen, outcome-trial regimen, single versus split dosing |
| 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 | ER Therapeutic Protocol provides more than three actionable aspects |
| 10.4 | All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section. |
🟢 |
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 | 🟢 | Cardiovascular events, LDL lowering (with PCSK9 fall within hours), plaque changes from ER Practical Considerations |
| 11.2 | The sets are picked and ordered by the magnitude of the related benefit | 🟢 | Events and LDL (High benefits) before plaque changes (Low benefit) |
| 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 | ER provides at least three time-to-effect aspects |
| 11.4 | All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER. | 🟢 | |
| 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 | ER provides time-to-effect information |
12. Benefits
| # | Description | Result | Comments |
|---|---|---|---|
| 12.1 | The section is derived from the ER Expected Benefits section |
🟢 | |
| 12.2 | Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] | 🟢 | |
| 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. | 🟢 | ER headings used without magnitudes |
| 12.4 | Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | |
| 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 have items |
13. Risks
| # | Description | Result | Comments |
|---|---|---|---|
| 13.1 | The section is derived from the ER Potential Risks & Side Effects section |
🟢 | |
| 13.2 | Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] | 🟢 | |
| 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. | 🟢 | ER headings used without frequencies |
| 13.4 | Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | |
| 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 have items |
14. Monitoring
| # | Description | Result | Comments |
|---|---|---|---|
| 14.1 | The section is derived from the ER Monitoring section |
🟢 | |
| 14.2 | All measurable/quantifiable biomarkers from the Monitoring section are listed |
🟢 | All 11 ER table biomarkers listed |
| 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. |
🟢 |
15. Qualitative Assessment
| # | Description | Result | Comments |
|---|---|---|---|
| 15.1 | The section is derived from the ER Monitoring section |
🟢 | |
| 15.2 | All subjective/qualitative biomarkers from the Monitoring section are listed |
🟢 | All six ER qualitative markers listed verbatim |
Issues 29/09/2026 05:21
Pass rate 100.00%. No issues found.
Issues 29/09/2026 05:19
- 1.1 — LDL time-to-effect misstated: Line 497 sets time_2_value to “4–8 weeks” under “LDL lowering”, which reads as though LDL takes 4–8 weeks to fall. The ER only says circulating PCSK9 falls within hours and LDL is measured at 4–8 weeks.
- 2.7 — Unexplained jargon “Subcutaneous”: Line 450 (action_1_sub) says “Subcutaneous injection” without the plain-language gloss “(under the skin)” that the ER gives in Therapeutic Protocol.
Fixes 29/09/2026 05:19
- 1.1 — LDL time-to-effect clarified: Changed time_2_value from “4–8 weeks” to “Measured at 4–8 weeks”. Changed time_2_sub to “Circulating levels of the blocked liver protein fall within hours”, which matches the ER wording.
- 2.7 — Subcutaneous jargon glossed: Changed action_1_sub from “Subcutaneous injection” to “Subcutaneous injection (under the skin)”, using the ER’s own gloss.
Issues 29/09/2026 05:16
- 9.4 — Trailing explanations in interactions: Seven of nine [caution_items] (lines 554-561) append consequence or explanation clauses after the action word, e.g. “Monitor; the 300 mg monthly dose can wane before the next injection” and “Monitor; niacin adds flushing and blood-sugar effects”, instead of just the key fact.
Fixes 29/09/2026 05:16
- 9.4 — Trailing explanations in interactions: Stripped the trailing consequence clauses from seven [caution_items] (Statins, nonstatin LDL-lowering drugs, Fibrates, Anticoagulants and antiplatelets, Red yeast rice, Berberine, Additive LDL-lowering supplements), leaving the ER label plus action word only; the co-injection instruction for other injectable drugs was kept as the key fact.
Issues 29/09/2026 05:13
- 2.15 — Lay route-of-administration phrasing: The At-A-Glance (line 433) says “given by injection under the skin”, a lay route phrasing that 2.15 explicitly excludes even in the lede.
- 9.4 — Statins item keeps rationale: The Statins interaction (line 554) retains the mechanistic rationale “faster alirocumab clearance, so …” rather than only the key fact that the 300 mg monthly dose can wane before the next injection.
Fixes 29/09/2026 05:13
- 2.15 — Lay route phrasing replaced: Changed “given by injection under the skin” to “administered by injection” in the At-A-Glance.
- 9.4 — Statins rationale stripped: Changed the Statins item from “Monitor; faster alirocumab clearance, so the 300 mg monthly dose can wane before the next injection” to “Monitor; the 300 mg monthly dose can wane before the next injection”.
Issues 29/09/2026 05:11
- 1.3 — Fibrate interaction hedge dropped: The fibrates item in Key Interactions (line 556) states “modestly reduced alirocumab exposure” as fact, while the ER says fibrates “can … modestly reduce alirocumab exposure”.
- 7.5 — Specialist term in At-a-Glance: The At-a-Glance text (line 433) uses “subcutaneous injection (under the skin)” instead of the plain-language “injection under the skin” alone.
Fixes 29/09/2026 05:11
- 1.3 — Fibrate interaction hedge restored: Changed the fibrates item from “modestly reduced alirocumab exposure” to “can modestly reduce alirocumab exposure”, matching the ER’s hedged wording.
- 7.5 — Plain-language route of administration: Replaced “subcutaneous injection (under the skin)” with “injection under the skin” in the At-a-Glance text.
Issues 29/09/2026 05:07
- 2.7 — Unexplained PCSK9 jargon: Line 500, time_2_sub, reads “Circulating PCSK9 falls within hours”. The specialist term “circulating PCSK9” is never explained on the sheet, and plain wording would carry the same fact.
- 2.15 — Lay route-of-administration phrasing: Line 433, the At a Glance lede, says “injected under the skin”. It should use the formal term “subcutaneous injection”, as the ER does (“by subcutaneous injection (under the skin)”).
Fixes 29/09/2026 05:07
- 2.7 — Unexplained PCSK9 jargon removed: Changed time_2_sub from “Circulating PCSK9 falls within hours” to “Blood levels of the blocked liver protein fall within hours”. The rest of the cell (“LDL is measured at 4–8 weeks”) is unchanged.
- 2.15 — Formal route of administration: Changed “injected under the skin” in At a Glance to “given by subcutaneous injection (under the skin)”. The plain-language gloss is kept, and the lede stays within 70 words.