Audit: QRS - Apitegromab for Muscle Growth

Audit conducted on 13/09/2026 16:43 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	93
Passed	83
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 content traced: at-a-glance to ER Conclusion, protocol cells to Therapeutic Protocol, time cells to the Practical Considerations time-to-effect bullet, gates to Key Interactions & Contraindications, markers and cadence to Monitoring Protocol & Defining Success.
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.	🟢	“This use is investigational, not approved”, “No interaction identified”, “Additive, not adverse” carried through unchanged.
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 and interaction severities match the ER exactly; “Caution”, “Caution with prolonged use” and “Monitor” are preserved at their ER strength.
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.	🟢	No Benefit- or Risk-Modifying Factor content appears in the gates; gate content comes solely from Key Interactions & Contraindications.
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.	🟢	The QRS carries no PMIDs, no NCT identifiers, no expert names and no brand names.
1.6	The QRS does not introduce new attributions.	🟢	ER investigator attributions (Pratley’s group, Crawford and Darras, Scholar Rock) were dropped rather than added to.

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 of the ER preserved throughout.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Tiered benefits and risks plus quantified marker targets keep the sheet data-driven without hedging or alarm.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Content is stated as findings and ranges, not instructions to a patient.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperative clinical directives; gates are stated as populations and agents, not orders.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No “recommended”, “should”, or “advised” phrasing in the document’s own voice.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the sheet.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms appear only where the ER itself uses them as marker or interaction names.
2.8	Information is presented in a concise and very compact manner	🟢	Benefits, risks, protocol and gate items are reduced to single clauses without mechanistic rationale.
2.9	It DOES NOT address the reader directly	🟢	Confirmed: no direct address in any span.
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 centres on off-label muscle use, monitoring targets and the fracture trade-off rather than on disease treatment alone.
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.	🟢	Monthly intravenous infusion, DEXA, densitometry and latent myostatin assays are presented without hedging about 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.	🟢	Content assumes willingness to run a specialist monitoring panel.
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.	🟢	The at-a-glance states plainly that strength did not improve and that all evidence is manufacturer-funded, the two points that matter most to 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 string “anti-aging” does not occur in the file.
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.	🟢	Route is given as “intravenous infusion” (line 453); “adverse events” used in the risks card (line 598); no lay substitutes anywhere.

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 headings, gate heads, tier labels and column headers match the template byte-for-byte.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 30 distinct template variable names are present; the repeating marker_#/qualitative_item_# rows are expanded to marker_1-8 and qualitative_item_1-5 (63 spans total).
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	<span website="evidence_review">, <span website="audit"> and <span website="full_review"> are unchanged, as are the footer disclaimer and all CSS.

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 feeding 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 (“Standard regimen”, “Lean-mass-preservation regimen”, “Higher-dose alternative”) and all ten interaction labels reproduce the ER bold labels, with only the lay-gloss clauses trimmed inside parentheses as item 9.5 permits.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	No invented labels; time-to-effect cell labels are taken from the wording of the ER’s own time-to-effect bullet.
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 in the file; the ER’s tier emoji were dropped correctly.
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 its shortest faithful form: mechanistic rationale, mitigations, magnitudes and context notes from the ER are all stripped.

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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.	🟢	Lines 2-14, immediately after the doctype on line 1.
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.	🟢	Opening “—” on line 3, closing “—” on line 13.
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.	🟢	Entirely within an HTML comment; no metadata value is repeated in the header or footer.
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.	🟢	Only duration: "00:02" is quoted, and it contains a colon.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	Line 4: er_filename: apitegromab_muscle_2026-0913-1447_Opus_ER.md.
5.6	Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]”	🟢	Line 5: qrs_prompt_version: 26.9.11, matching the QRS.md badge.
5.7	Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430)	🟢	Line 6: qrs_creation_date: 2026-0913-1638.
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢	Line 7: 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)	🟢	“Opus” is a single word without version.
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢	Line 8: 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)	🟢	“Opus 5” carries no additional qualifier.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	Line 9 matches the actual filename apitegromab_muscle_2026-0913-1447_Opus_QRS.html.
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.	🟢	Re-verified across all nine keys; no stray whitespace or unnecessary 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 &)	🟢	Line 22: “Apitegromab for Muscle Growth - Quick Reference Sheet”; no characters require entity encoding.
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	Line 417: “Apitegromab for Muscle Growth”, identical to the ER canonical_topic.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	Line 421: “09/13/2026”, matching qrs_creation_date 2026-0913.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	Line 425: “Opus 5”.
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 holds only the title and the template subline; the ER’s “Also known as” line was not carried over.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Lines 434-438 compress all four Conclusion paragraphs: approved indication, lean-mass retention, decay after stopping, absent strength gain, fracture warning, manufacturer funding.
7.2	[at_a_glance] is no longer than 60 words	🟢	55 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Each clause maps to ER lines 431-435 (modest movement gain, retained muscle, advantage faded within two months, no strength gain, labelled fracture warning, manufacturer-funded trials).
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; “a natural brake on muscle growth” and “a rare inherited muscle-wasting disease” replace myostatin and spinal muscular atrophy.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial name, year, n or p-value appears.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	Only qualitative descriptors (“modestly”, “much of the muscle”) are used.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All six items come from the “Populations who should avoid Apitegromab” list, ER lines 283-288.
8.2	[stop_items] represent the Contraindications from the ER	🟢	All six ER avoid-populations are present, none added.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Lines 563-568, six <li> elements inside the 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.	🟢	ER rationale clauses (“since fetal effects are unknown…”, “which names apitegromab explicitly…”) are all stripped; no dash-trailing content remains.
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).	🟢	The T-score threshold “at or below -2.5”, the five-month pregnancy window and the “under 2 years” age cut are all retained.
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 uses no ranking notation in this section.
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.	🟢	The ER does identify such populations and the section is correctly populated.
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	The section is not empty.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All ten items come from the ER bullet list at lines 261-279.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	All ten ER interaction bullets are represented; none duplicates a contraindication.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Lines 576-585, ten <li> elements inside the 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.	🟢	Each item is reduced to label plus the ER’s own verdict (“Caution”, “Monitor”, “Additive, not adverse”); all mechanism and mitigation sentences are stripped.
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).	🟢	Every ER example-drug list is retained in full; only the lay definitional glosses (“anti-inflammatory steroid drugs;”, “stomach-acid blockers;”) were trimmed.
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 uses no ranking notation in this section.
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.	🟢	The ER does identify interactions and the section is correctly populated.
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	The section is not empty.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	All three cells come from the ER Therapeutic Protocol bullets at lines 310-314.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	The three dosing regimens (standard, lean-mass-preservation, higher-dose alternative) are the only actionable regimens in the ER section; the remaining bullets are “none established” qualifiers.
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 aspects exist and all three 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.	🟢	Lines 450-487: all nine spans carry ER-derived dosing, route, frequency and approval status.

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	🟢	Motor function at 12 months, lean mass at 24 weeks and target engagement at week 16 are exactly the three aspects in the ER “Time to effect” bullet (line 360).
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Order follows the benefit tiers: motor function (High), lean mass (Medium), then target engagement, which is a pharmacodynamic marker rather than a 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	Three distinct time-to-effect aspects exist and all three sets are used.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢	Lines 497-529: all nine spans carry ER-derived intervals and context.
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 does provide time-to-effect information.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	All four tiers map to the ER Expected Benefits headings at lines 143-173.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present at lines 539-553.
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 tier carries only the ER benefit headings; the 2.2-point HFMSE advantage, the 1.9 kg figure and the conflict flags are all stripped.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses remain 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 tiers carry items in the ER.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	All four tiers map to the ER headings at lines 195-245.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present at lines 597-615.
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.	🟢	Only the ER risk headings are carried; the 9% vs 2% fracture rates and the labelling discussion are stripped.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses remain 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 tiers carry items in the ER.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	All rows come from the ER biomarker table at lines 392-401.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All eight ER biomarkers are present, with the ER’s optimal ranges and “Why Measure It?” text carried over unchanged.
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.	🟢	Lines 723-728 reproduce the ER ongoing-monitoring schedule at line 390.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	All five items come from the ER qualitative-marker list at lines 405-409.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All five ER qualitative markers are present and unaltered.

Issues 13/09/2026 16:43

Pass rate 100.00%. No issues found.