Audit: QRS - Canagliflozin for Health & Longevity

Audit conducted on 09/09/2026 07:26 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

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 benefit/risk tier entries map 1:1 to ER Expected Benefits and Potential Risks & Side Effects headings; protocol, time-to-effect, monitoring and qualitative content traces to ER lines 425–441, 478 and 504–528.
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. 🟢 The only cautious formulation carried over is marker_12_target “No established target on this drug; track change from the individual’s own baseline lean mass”, reproduced verbatim from the ER table.
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”). 🟢 Contraindications retain absolute force (“dialysis or end-stage kidney disease outright”); interactions retain their advisory register.
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. 🟢 [stop_items] draw only from the ER “Populations who should avoid Canagliflozin” list; [caution_items] only from the ER interaction bullets; no Benefit- or Risk-Modifying Factor appears in either gate.
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 IDs or brand names appear. “AgelessRx” is the sole named entity and is attached to the same two protocols in ER lines 429 and 431.
1.6 The QRS does not introduce new attributions. 🟢 The single attribution (AgelessRx popularising the daily and pulsed protocols) is the ER’s own.

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. 🟢 Detached, descriptive 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 🟢 Quantified targets in Monitoring, plain-language At-A-Glance, no alarmist or promotional framing.
2.3 The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor 🟢 Content is stated as observation (“Feet checked daily, and formally at each review”), not instruction.
2.4 The QRS avoids language that implies medical or clinical advice 🟢 No imperative or second-person constructions in the QRS’s own voice.
2.5 The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” 🟢 No occurrence of “recommend”, “advise”, “should” or “must” anywhere in the file.
2.6 The QRS never addresses “the reader” directly — it presents evidence, not guidance 🟢 No “you”/”your” in any populated span.
2.7 The QRS is written in plain language, avoiding unnecessary medical jargon 🟢 Technical terms are confined to the Monitoring marker names, where they are the assay names themselves; glosses are used elsewhere (“dangerous acid buildup”).
2.8 Information is presented in a concise and very compact manner 🟢 Benefit and risk tiers are bare semicolon-separated headings; gate items are stripped to the key fact.
2.9 It DOES NOT address the reader directly 🟢 Confirmed by full-file search for second-person pronouns.
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. 🟢 The two Protocol regimens selected are the longevity-oriented off-label ones, not the licensed diabetes regimen.
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. 🟢 A 12-marker monitoring panel plus daily foot checks is presented without hedging on 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. 🟢 Off-label longevity dosing and beta-hydroxybutyrate home testing presume a highly engaged reader.
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 localises the outcome benefits to “people with diabetes and kidney or heart disease” and states “The longevity case rests almost entirely on mice.”
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. 🟢 Uses “Longevity-oriented daily regimen”, “longevity telehealth clinic”; no occurrence of “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. 🟢 “prescription medicine”, “osmotic diuresis”, “hypersensitivity reactions”; no “pill”, “shot” or equivalent.

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”
🟢 Structural diff against [qrs_template] shows every heading, gate head, tier label and column header byte-identical.
3.2 All “…” from the [qrs_template] are present in the the QRS. 🟢 All 38 template variables present; the repeatable marker_#_* and qualitative_item_# placeholders are expanded to 12 and 6 instances respectively.
3.3 Spans that are not addressed in a checklist item are left unchanged 🟢 The website="evidence_review", website="audit" and website="full_review" spans, the CSS block, the override stylesheet link and the footer disclaimer are unmodified.

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 that feeds 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. 🟢 “Longevity-oriented daily regimen”, “Longevity-oriented pulsed regimen” and “Best time of day” reproduce ER bold labels at lines 429, 431 and 435 verbatim.
4.3 Labels are not paraphrased, abbreviated, or invented. 🟢 Monitoring row labels match the ER biomarker column verbatim for all 12 rows; the three time-to-effect labels are lifted from the ER’s own phrasing in line 478.
4.4 The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. 🟢 No emoji in the file; the ER’s “⚠️ Conflicted” markers are correctly dropped.
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 discretionary section is condensed to the floor the other items permit: tiers are bare headings, gate items stripped of rationale, [at_a_glance] at 58 of 60 words. Remaining volume is compelled by items 8.2, 9.2, 14.2 and 15.2.

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 <!doctype html> 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 --- at line 3, closing --- at line 13; the preamble text on line 2 sits before the opener.
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; none of its values are echoed except those the template independently binds (date, model).
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. 🟢 No trailing whitespace on lines 3–13; only duration: "00:02" is quoted, which is required because the value contains a colon.
5.5 The filename of the source ER is stated as “er_filename: [er_filename]” 🟢 Line 4: er_filename: canagliflozin_2026-0909-0527_Opus_ER.md, matching the ER’s own filename frontmatter key.
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: 26.7.02, matching 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) 🟢 Line 6: qrs_creation_date: 2026-0909-0713.
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” — single word, no 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” — nickname plus version, no qualifier.
5.12 The filename of the document is stated as “qrs_filename: [filename of this document]” 🟢 Line 9: qrs_filename: canagliflozin_2026-0909-0527_Opus_QRS.html, matching 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. 🟢 Re-verified across all nine keys including the appended duration, git_user and git_issue.

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 &) 🟢 Line 22: “Canagliflozin 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 &) 🟢 Line 417: “Canagliflozin for Health & Longevity”, matching ER frontmatter line 8.
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢 Line 421: “09/09/2026”, from qrs_creation_date: 2026-0909-0713.
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 contains only the title and the template’s own subline; the ER’s “Also known as” line is 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 🟢 Compresses ER lines 552–556: mechanism, benefit cluster, population caveat, two headline harms, and the mouse-only longevity basis.
7.2 [at_a_glance] is no longer than 60 words 🟢 58 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 in the ER Conclusion (lines 552, 554, 556).
7.4 It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead 🟢 No acronyms; “dangerous acid buildup” stands in for ketoacidosis and “flush sugar into the urine” for SGLT2 inhibition.
7.5 It DOES NOT cite specific trials (names, years, sample sizes, p-values) 🟢 No trial names, years or sample sizes; CANVAS and CREDENCE are not mentioned.
7.6 It DOES NOT cite effect sizes, relative risks, or statistical results 🟢 No hazard ratios, confidence intervals or numeric effect sizes.

8. Contraindications

# Description Result Comments
8.1 The section is derived from the ER Key Interactions & Contraindications section 🟢 Drawn from ER lines 393–401, “Populations who should avoid Canagliflozin”.
8.2 [stop_items] represent the Contraindications from the ER 🟢 All 7 ER bullets are present, one-for-one and in ER order.
8.3 Individual [stop_items] are formatted as <li></li> 🟢 7 <li> elements inside the [stop_items] span (lines 557–567).
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 stripped throughout, e.g. “given the high risk of ketoacidosis at normal blood sugar”, “on juvenile animal kidney toxicity data” and “where the drug has not been studied” all removed; no dash-trailing clauses remain.
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). 🟢 “(Child-Pugh Class C)”, “eGFR below 30 mL/min/1.73 m²”, “second and third trimesters” and “Within 3 days of planned surgery” all retained; only the plain-language glosses were trimmed.
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 contains no ranking notation.
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 names seven such populations and the section is correctly populated rather than empty.
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 🟢 Drawn from the nine interaction bullets at ER lines 375–391.
9.2 [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications 🟢 All 9 ER interaction bullets present in ER order; none duplicates a contraindication.
9.3 Individual [caution_items] are formatted as <li></li> 🟢 9 <li> elements inside the [caution_items] span (lines 575–585).
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. 🟢 Caution/Monitor labels, mechanisms and all “Mitigation:” clauses removed; the ER’s in-paren glosses after em-dashes (e.g. “— medicines that increase urine output”) are correctly 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 named-drug list is retained in full: glimepiride/glipizide/glyburide; furosemide/hydrochlorothiazide; rifampicin/phenytoin/phenobarbital/ritonavir; ibuprofen/naproxen/diclofenac; spironolactone/lisinopril/losartan; and the seven-supplement list.
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 contains no ranking notation.
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 names nine such interactions and the section is correctly populated rather than empty.
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 trace to ER Therapeutic Protocol lines 429, 431 and 435.
10.2 The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section 🟢 Dose (100 mg daily), the alternative pulsed dose (150 mg every other day) and timing (before the first meal) — the three decisions a longevity-oriented reader must actually make; the licensed diabetes regimens are correctly deprioritised for this audience.
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 The ER Therapeutic Protocol section contains twelve actionable bullets, well above three.
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 spans populated; labels verbatim from the ER, values and subs condensed from the same 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 🟢 Kidney/heart outcomes, weight and blood pressure/urate, all from ER line 478; the fourth aspect (glucose excretion from the first dose) is folded into [time_3_sub] rather than dropped.
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢 Order matches the ER’s own High-tier benefit ordering: Kidney Protection and heart-failure/MACE reduction first, then Weight Reduction, then Lower Blood Pressure and Lower Serum Urate.
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 The ER names four distinct time-to-effect aspects at line 478.
11.4 All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER. 🟢 All nine time spans populated; “8–12 weeks”, “Days to 2 weeks” and “Years” match ER line 478, and [time_2_sub] reproduces the plateau mechanism from ER line 181.
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, line 478), so the section is correctly retained.

12. Benefits

# Description Result Comments
12.1 The section is derived from the ER Expected Benefits section 🟢 All fourteen entries correspond to ER Expected Benefits sub-headings, in ER order and ER tier.
12.2 Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] 🟢 All four spans present and populated (lines 533–547).
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 entry is the bare ER sub-heading; no hazard ratios, confidence intervals or Magnitude text carried through.
12.4 Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 No parentheses appear in any benefits span.
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 ER benefit tiers contain items, so no span needed hiding.

13. Risks

# Description Result Comments
13.1 The section is derived from the ER Potential Risks & Side Effects section 🟢 All fifteen entries correspond to ER Potential Risks & Side Effects sub-headings, in ER order and ER tier.
13.2 Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] 🟢 All four spans present and populated (lines 597–612).
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 entry is the bare ER sub-heading; the “⚠️ Conflicted” qualifiers and all Magnitude figures are dropped.
13.4 Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 No parentheses appear in any risks span.
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 ER risk tiers contain items, so no span needed hiding.

14. Monitoring

# Description Result Comments
14.1 The section is derived from the ER Monitoring section 🟢 Table and cadence both drawn from ER Monitoring Protocol & Defining Success, lines 504–519.
14.2 All measurable/quantifiable biomarkers from the Monitoring section are listed 🟢 All 12 ER table rows present in ER order, with Target and Why columns reproduced verbatim; the ER’s fourth “Context/Notes” column is correctly not carried over.
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 775–778 condense ER line 504: baseline panel, 2 and 4 weeks, 3 months with lipids and haematocrit, 6-monthly once stable, bone density at 2 years, daily foot checks.

15. Qualitative Assessment

# Description Result Comments
15.1 The section is derived from the ER Monitoring section 🟢 Drawn from the qualitative-marker bullet list at ER lines 523–528.
15.2 All subjective/qualitative biomarkers from the Monitoring section are listed 🟢 All 6 ER bullets present, verbatim and in ER order.

Issues 09/09/2026 07:26

Pass rate 100.00%. No issues found.

Issues 09/09/2026 07:18

  1. 11.4 — Time-to-effect sub mismatched to its cell: At line 522 [time_3_sub] states “Glucose excretion itself begins with the first dose”, but the cell it sits under is labelled “Blood pressure and urate” with the value “Days to 2 weeks”, so the sub-caption explains a different endpoint than its own label and value.

Fixes 09/09/2026 07:18

  1. 11.4 — Time-to-effect sub mismatched to its cell: Rewrote [time_3_sub] from “Glucose excretion itself begins with the first dose.” to “Shifts within days to two weeks, while glucose excretion itself begins with the first dose.”, so the sub-caption now elaborates its own “Blood pressure and urate” cell while retaining the ER’s first-dose glucose fact.