Audit: QRS - Chemical Peel for Skin Rejuvenation

Audit conducted on 11/09/2026 09:20 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 protocol values (glycolic 20–70%/2–5 min, Jessner’s + 35% TCA, phenol 88% + croton oil 0.1–0.8%), time-to-effect windows, all 10 biomarker targets, cadence, benefits, risks, gates and qualitative markers trace to ER lines 385–399, 446, 416, 476–498, 154–216, 238–308, 328–361.
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 ER phrasing is carried where it survives condensation; the HSV serostatus row keeps the ER’s “No established target value; serostatus and prophylaxis adherence are tracked instead” verbatim (ER line 489).
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”). 🟢 Pregnancy/breastfeeding stays a contraindication, not a caution; isotretinoin stays depth-qualified as in ER line 352; no tier or gate was moved.
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. 🟢 Gates draw only from Key Interactions & Contraindications; benefits from Expected Benefits; risks from Potential Risks & Side Effects. No Benefit- or Risk-Modifying Factor (ER lines 221–231, 313–323) leaks into any card.
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 present. Eponymous terms (“Jessner’s”, “Fitzpatrick”, “Glogau”, “Child-Pugh”) are named scales/solutions used identically in the ER.
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. 🟢 Neutral, depth-centred framing mirrors the ER’s own “depth decides everything” logic.
2.2 The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging 🟢 Quantified targets and depth tiers throughout; the lede sets expectation without discouraging.
2.3 The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor 🟢 Items are stated as facts and ranges, not orders.
2.4 The QRS avoids language that implies medical or clinical advice 🟢 No “should”, “must” or dosing instruction directed at a reader.
2.5 The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” 🟢 Cadence and protocol cells are descriptive/passive (“Applied segmentally under sedation”), echoing ER lines 391–399 and 476.
2.6 The QRS never addresses “the reader” directly — it presents evidence, not guidance 🟢 No second-person pronoun occurs anywhere in the file.
2.7 The QRS is written in plain language, avoiding unnecessary medical jargon 🟢 Technical terms retained are those the ER’s own section headings use; the lede substitutes plain equivalents (“precancerous sun spots”, “brown patches”).
2.8 Information is presented in a concise and very compact manner 🟢 Every card is reduced to noun-phrase items; no prose beyond the 58-word lede and the cadence line.
2.9 It DOES NOT address the reader directly 🟢 Confirmed — no “you”/”your” anywhere in the document.
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. 🟢 Content assumes willingness to screen ECG/eGFR/HbA1c and to run a multi-month series.
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. 🟢 Qualitative markers explicitly weigh downtime against change achieved.
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. 🟢 Monitoring panel and phenol gating are far beyond general-population framing.
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 lede names the modest wrinkle signal alongside the stronger pigment and precancerous-lesion signal, matching ER line 522.
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 document.
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 and agent terms are formal throughout (“oral isotretinoin”, “topical retinoids”, “sedation”, “co-oximetry”); the lede’s plain nouns are the ER’s own conclusion 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 present byte-identical to [qrs_template] (lines 437, 474, 516, 536, 542, 553, 572, 576–578, 603).
3.2 All “…” from the [qrs_template] are present in the the QRS. 🟢 Set comparison against the template returns no missing variable; the repeatable marker_#_* and qualitative_item_# families are expanded to marker_1..10_* and qualitative_item_1..6.
3.3 Spans that are not addressed in a checklist item are left unchanged 🟢 website="evidence_review", website="audit" and website="full_review" are untouched, as are all CSS, the override stylesheet link and the footer disclaimer.

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 ER section feeding the QRS is empty — Protocol, Benefits, Risks, Interactions/Contraindications and Monitoring are all fully populated.
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 are the ER’s bold labels verbatim: “Superficial glycolic acid peel”, “Medium-depth combination peel”, “Deep phenol-croton oil peel” (ER lines 385, 389, 391).
4.3 Labels are not paraphrased, abbreviated, or invented. 🟢 Biomarker names and tier labels are copied from the ER table (lines 480–489); the time-to-effect labels use the ER’s own depth terms from line 446.
4.4 The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. 🟢 No emoji code points occur in the file; the ER’s “⚠️ Conflicted” markers were 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 card is compressed to the minimum the mandatory-coverage items (8.2, 9.2, 14.2, 15.2) permit; no section carries prose that could be cut without dropping required content.

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; nothing precedes it but 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; the caption text sits on line 2.
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; no element mirrors the values.
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: "00:03" is quoted, correctly, because it contains a colon.
5.5 The filename of the source ER is stated as “er_filename: [er_filename]” 🟢 Line 4: er_filename: chemical_peel_skin_2026-0911-0557_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: 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: 2026-0911-0915.
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: 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.
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: 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 such as “(1M context)”.
5.12 The filename of the document is stated as “qrs_filename: [filename of this document]” 🟢 Line 9 matches the on-disk filename exactly.
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 redundant 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 &) 🟢 Line 22: “Chemical Peel for Skin Rejuvenation - 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., &amp; for &) 🟢 Line 417: “Chemical Peel for Skin Rejuvenation”, matching ER frontmatter line 8.
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢 Line 421: 09/11/2026, the correct reformatting of 2026-0911.
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 block (lines 415–428) is the template’s structure with only the two variables filled; the ER’s long “Also known as” list was correctly 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 🟢 Condenses ER line 522 — depth as the governing variable, the shallow-versus-deep trade, and where the evidence is strongest.
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. 🟢 Controlled destruction and regrowth (ER 522/37); shallow clearing roughness, brown patches, acne marks in days (522); deep reshaping for a decade at weeks of recovery with permanent colour change (522/416); pigment and precancerous sun spots strongest, wrinkles modest (522).
7.4 It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead 🟢 No acronyms; “actinic keratoses” rendered as “precancerous sun spots”, “melasma” as “brown patches”, “post-inflammatory hyperpigmentation” as “acne marks”.
7.5 It DOES NOT cite specific trials (names, years, sample sizes, p-values) 🟢 No trial, author, year or sample size appears.
7.6 It DOES NOT cite effect sizes, relative risks, or statistical results 🟢 No numeric effect estimate; only the qualitative “modest”.

8. Contraindications

# Description Result Comments
8.1 The section is derived from the ER Key Interactions & Contraindications section 🟢 All 11 items map to ER lines 328/334 and the “Populations who should avoid Chemical Peel” list at lines 352–361.
8.2 [stop_items] represent the Contraindications from the ER 🟢 All 10 avoid-list bullets are carried, plus the QT-prolonging medication bullet the ER marks “Absolute contraindication for phenol peels” (line 334).
8.3 Individual [stop_items] are formatted as <li></li> 🟢 Lines 572–582: eleven discrete <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. 🟢 The ER’s explanatory gloss on Fitzpatrick phototype (“the darkest two grades on a six-point scale…”, line 355) is stripped; no item carries rationale, citation or a trailing dash clause.
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). 🟢 Preserved throughout: “6 months”, “(medium-depth and deep peels)”, “QT interval above 470 ms”, “Child-Pugh Class B or C”, “below 60 mL/min/1.73 m²”, “(glycated hemoglobin above 8%)”, “(phenol peels)”, “beyond very superficial alpha-hydroxy acid”.
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 inside parentheses in its contraindication list.
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 section is populated, as required — the ER names ten such populations plus two absolute contraindications.
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 nine items map one-to-one to ER bullets at lines 330–348.
9.2 [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications 🟢 The ER’s eleven interaction bullets minus the two absolute contraindications (oral isotretinoin, QT-prolonging medication) yield exactly the nine items listed.
9.3 Individual [caution_items] are formatted as <li></li> 🟢 Lines 590–598: nine discrete <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. 🟢 Mechanism and mitigation sentences from ER lines 330–348 are stripped; no citations, no trailing dash clauses.
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). 🟢 Named examples preserved: “(tretinoin, adapalene, tazarotene)”, “(doxycycline, ciprofloxacin, hydrochlorothiazide, amiodarone)”, “(aspirin, salicylate rubs, acne washes)”, “(St John’s wort, high-dose niacin, bergamot or citrus essential oils)”, “(fish oil, high-dose vitamin E, ginkgo, garlic extract)”, “(oral tranexamic acid, Polypodium leucotomos)”, “(microneedling, fractional laser, photodynamic therapy)”, plus “(additive benefit)”.
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 inside parentheses in its interaction bullets.
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 section is populated, as required — the ER names nine non-contraindication 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 The section is not empty.

10. Protocol

# Description Result Comments
10.1 The section is derived from the ER Protocol section 🟢 All three cells derive from ER Therapeutic Protocol lines 385, 389, 391 and 399.
10.2 The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section 🟢 One protocol per depth tier — superficial glycolic, medium-depth Jessner’s + TCA, deep phenol-croton oil — which is the axis the ER identifies as governing the whole intervention.
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 names four distinct protocols; 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. 🟢 All nine spans carry ER-sourced content: concentrations, contact times, neutralization, session spacing, the Monheit standard plus the Coleman and Brody alternatives, and segmental phenol application at 10–15 minute intervals.

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 🟢 The ER’s Time to effect bullet (line 446) names exactly three windows — deep, medium, superficial — and all three are carried.
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢 Deep → medium → superficial, matching the ER’s depth-equals-magnitude logic (lines 424, 450, 522).
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 aspects exist; 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. 🟢 All nine spans populated; the deep-peel sub-line adds the ER’s own durability statement “results reported to persist a decade or longer” (line 416).
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 data at line 446, so the section is correctly retained.

12. Benefits

# Description Result Comments
12.1 The section is derived from the ER Expected Benefits section 🟢 All ten items correspond to the ER’s ten benefit headings (lines 156–216).
12.2 Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] 🟢 All four spans present and populated at lines 541–562.
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 item is the ER heading reduced to a noun phrase; every Magnitude: line (4.34%, MASI −1.89, RR 2.30, 12–46% clearance) is stripped.
12.4 Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 The ER’s glosses (“rough precancerous sun spots that can progress to…”, “flat brown spots from cumulative light exposure”, “GAGs, water-binding sugars…”) are all removed.
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, 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 eleven items correspond to the ER’s eleven risk headings (lines 240–308).
13.2 Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] 🟢 All four spans present and populated at lines 610–629.
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. 🟢 Frequencies (5.9%, 6 of 12, 21%, 25%), the RR 4.42 comparison and the “⚠️ Conflicted” marker on the isotretinoin item are all stripped.
13.4 Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 ER glosses (“PIH, brown staining where inflamed skin has healed”, “HSV, the cold-sore virus”, “tiny white keratin cysts”) are removed.
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, so no span needed hiding.

14. Monitoring

# Description Result Comments
14.1 The section is derived from the ER Monitoring section 🟢 Rows and cadence come from the ER Monitoring Protocol & Defining Success section, lines 476–489.
14.2 All measurable/quantifiable biomarkers from the Monitoring section are listed 🟢 All 10 ER table rows are present in order, with Target and Why columns copied verbatim (Fitzpatrick phototype, Glogau grade, ECG/QTc, creatinine/eGFR, ALT/AST, HbA1c, methemoglobin, serum salicylate, 25-hydroxyvitamin D, HSV IgG).
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 779–783 carry the full ER schedule — 48–72 h, 2 weeks, 6–8 weeks, 3 and 6 months, then every 6–12 months — plus the phenol-only laboratory repeat at 24 hours (ER line 476).

15. Qualitative Assessment

# Description Result Comments
15.1 The section is derived from the ER Monitoring section 🟢 Items come from the ER’s “Qualitative markers that define whether the result is worth the cost” list, lines 493–498.
15.2 All subjective/qualitative biomarkers from the Monitoring section are listed 🟢 All six ER bullets are present, in order and essentially verbatim, at lines 791–824.

Issues 11/09/2026 09:20

Pass rate 100.00%. No issues found.