Audit: QRS - Avoiding Tyramine for Health & Longevity

Audit conducted on 23/06/2026 04:38 using AI4L / Opus 4.8

Iterations

Summary

Items Count
Total 91
Passed 87
Failed 0
N/A 4
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. 🟢  
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. 🟢 “Speculative” tier and “may need little or none” preserve ER caution.
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”). 🟢  
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/Key Interactions drawn from ER Key Interactions & Contraindications section.
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 citations or expert names introduced.
1.6 The QRS does not introduce new attributions. 🟢  

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 second-person address used.
2.7 The QRS is written in plain language, avoiding unnecessary medical jargon 🟢  
2.8 Information is presented in a concise and very compact manner 🟢  
2.9 It DOES NOT address the reader directly 🟢  
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. 🟢 At-a-glance distinguishes medicated subgroup vs. healthy adults.
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. 🟢 “longevity” used in title; no “anti-aging”.
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. 🟢 Body uses “MAO inhibitor”, “RIMA”, “selegiline”; at-a-glance plain language per 7.4.

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 labels verbatim.
3.2 All “” from the [qrs_template] are present in the the QRS. 🟢 All template spans present (marker_# and qualitative_item_# expanded).
3.3 Spans that are not addressed in a checklist item are left unchanged 🟢  

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” 🟢 No empty ER sections requiring empty-state phrasing.
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. 🟢 Benefit/risk tier labels match; protocol cells are distilled actionable aspects, not 1:1 bullet mappings.
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 indicators 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. 🟢 Content condensed; combined speculative/medium items.

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. 🟢 Comment opens at line 2.
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 (contains colon); others unquoted.
5.5 The filename of the source ER is stated as “er_filename: [er_filename]” 🟢 er_filename: avoiding_tyramine_2026-0623-0353_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]” 🟢 qrs_prompt_version: 26.5.18
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: 2026-0623-0353
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) 🟢  
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 4.8
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]” 🟢 qrs_filename: avoiding_tyramine_2026-0623-0353_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. 🟢  

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., &amp; for &) 🟢 “Avoiding Tyramine for Health & Longevity - Quick Reference Sheet”
6.2 [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., &amp; for &) 🟢  
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢 06/23/2026
6.4 [header_subline_model] is set to [qrs_creator_ai_fullname] 🟢 Opus 4.8
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] is dense, execution-oriented summary of the ER Conclusion section 🟢 Mirrors Conclusion’s two-population framing.
7.2 [at_a_glance] is no longer than 60 words 🟢 54 words.
7.3 Every fact in [at_a_glance] is supported by a distinct passage in the ER. 🟢  
7.4 It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead 🟢 “older drugs that disable the body’s main tyramine-clearing enzyme” instead of MAOI.
7.5 It DOES NOT cite specific trials (names, years, sample sizes, p-values) 🟢  
7.6 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 🟢 Irreversible non-selective MAO inhibitors; high-dose selegiline.
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 — these trailing clauses are stripped. Just the key fact. 🟢  
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). 🟢 Drug examples (phenelzine, tranylcypromine, isocarboxazid) preserved in parens.
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. 🟢 No ranking notation present; examples are comma-separated.
8.7 If no [stop_items] are present the section is left empty N/A stop_items are present.

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 🟢 RIMAs, MAO-B-selective/transdermal selegiline, OTC sympathomimetics, supplement interactions.
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 — these trailing clauses are stripped. Just the key fact. 🟢  
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 drugs (moclobemide, pseudoephedrine, phenylephrine, bitter orange/synephrine, octopamine, hordenine) preserved.
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. 🟢 No ranking notation; comma-separated.
9.7 If no [caution_items] are present the section is left empty N/A caution_items are present.

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 🟢 Targeted approach; match to medication; avoid large single-meal load.
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 are present.
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 🟢 Two distinct time-to-effect aspects exist in ER; both presented.
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢 time_1 = MAO-inhibitor (High benefit); time_2 = headache (Medium 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. 🟢 time_3 set hidden via display:none.
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. 🟢  
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. 🟢 benefits_low hidden (no Low tier in ER).

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. 🟢  
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. 🟢 risks_high hidden (no High tier in ER).

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 🟢 BP, heart rate, plasma free metanephrines listed; genotype hidden per ER note “not a monitoring marker”.
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 four ER qualitative markers listed.

Issues 23/06/2026 04:38

Pass rate 100.00%. No issues found.

Issues 23/06/2026 04:31

  1. 14.2 — Genotype listed as monitoring marker: The Monitoring table includes “MAO-A / OCT1 / CYP2D6 genotype” (marker_3, QRS line 617), but the ER’s Context/Notes for this row (ER line 339) explicitly states it is a “One-time test; not routine … not a monitoring marker,” so it should not appear among the measurable monitoring biomarkers.

Fixes 23/06/2026 04:31

  1. 14.2 — Genotype removed from Monitoring: Hid the “MAO-A / OCT1 / CYP2D6 genotype” row (marker_3) in the Monitoring table via display:none, since the ER labels it a one-time test and “not a monitoring marker”; the table now lists only the three measurable monitoring biomarkers.

Issues 23/06/2026 04:25

  1. 11.1 — Third time-to-effect is a maintenance window: The third Time-to-Effect cell, “After stopping inhibitor / ~2 weeks” (QRS lines 503-513), is a discontinuation/enzyme-regeneration maintenance window drawn from the ER’s Protocol/Discontinuation sections (ER lines 268, 285), not one of the ER’s time-to-effect aspects; the ER’s “Time to effect” (line 307) offers only two genuine aspects.

Fixes 23/06/2026 04:25

  1. 11.1 — Removed non-time-to-effect cell: Cleared the third Time-to-Effect cell (“After stopping inhibitor / ~2 weeks”, a discontinuation/maintenance window) and set it to display:none, leaving only the ER’s two genuine time-to-effect aspects.