Audit: QRS - Elamipretide for Health & Longevity
Audit conducted on 30/08/2026 02:02 using AI4L / Opus 5
Summary
| Items | Count |
|---|---|
| Total | 93 |
| Passed | 84 |
| Failed | 0 |
| N/A | 9 |
| 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. | 🟢 | Spot-checked every populated span against the ER: protocol cells vs ER lines 334/336/342/346/356, time cells vs ER 153/393, benefit and risk items vs the ER tier headings, monitoring rows vs the ER biomarker table, qualitative items vs ER 435-439. All literally supported. |
| 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 carried over verbatim: “No circadian data exist”, “No age-, sex- or pharmacogenetic adjustment is specified”, “No established target”. |
| 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 claim strengthened or softened; contraindications keep absolute framing, speculative tiers stay speculative. |
| 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 the ER’s “Populations who should avoid” list, interactions from the ER interaction bullets, risks from Potential Risks; no cross-category migration. |
| 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 identifiers, expert names or brand names (Forzinity/Bendavia) appear in the QRS. |
| 1.6 | The QRS does not introduce new attributions. | 🟢 | No attributions introduced. |
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. | 🟢 | Matches the ER’s sober, skeptical register. |
| 2.2 | The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging | 🟢 | Expert, objective and data-driven; the deflationary emphasis mirrors the ER’s own conclusion rather than editorialising. |
| 2.3 | The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor | 🟢 | Presents evidence and thresholds; no prescriptive voice. |
| 2.4 | The QRS avoids language that implies medical or clinical advice | 🟢 | No imperatives or advice constructions; footer disclaimer intact. |
| 2.5 | The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” | 🟢 | Information is stated, not recommended. |
| 2.6 | The QRS never addresses “the reader” directly — it presents evidence, not guidance | 🟢 | No second-person address anywhere in the file. |
| 2.7 | The QRS is written in plain language, avoiding unnecessary medical jargon | 🟢 | Technical terms retained only where the decision gates require precision (drug names, biomarker names); at-a-glance uses plain language. |
| 2.8 | Information is presented in a concise and very compact manner | 🟢 | Compact throughout; sub-cells are one to three short sentences. |
| 2.9 | It DOES NOT address the reader directly | 🟢 | Confirmed: no “you”/”your” 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 is pitched at a proactive, risk-aware longevity reader. |
| 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. | 🟢 | Daily subcutaneous injection, monitoring cadence and functional retesting are presented without hedging about inconvenience. |
| 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. | 🟢 | Not framed for a general audience. |
| 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. | 🟢 | Surfaces the longevity-relevant signals (aging-muscle energetics, speculative frailty/cognition) alongside the disease-population evidence. |
| 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 occurrence of “anti-aging”; the document uses “longevity”. |
| 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. | 🟢 | Formal terminology in the document’s own voice; the plain-language phrasing in at-a-glance is required by item 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 headings, gate headings, tier labels and Monitoring column headers are byte-identical to the template. |
| 3.2 | All “…” from the [qrs_template] are present in the the QRS. | 🟢 | All 34 template variables present; verified by set comparison against the template (no missing, no extra). |
| 3.3 | Spans that are not addressed in a checklist item are left unchanged | 🟢 | The three website=”…” spans and all non-variable markup are unchanged; a structural diff against the template shows changes only inside variable regions. |
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 mapped into the QRS is empty; the absent High benefit tier is governed by item 12.5, not by this item. |
| 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 reuse the ER bold labels verbatim: “Standard approved regimen”, “Best time of day”, “Pre-existing conditions influencing response”. |
| 4.3 | Labels are not paraphrased, abbreviated, or invented. | 🟢 | No ER label paraphrased or abbreviated. The Time-to-effect cell labels have no ER bold label to copy (the ER carries a single “Time to effect:” bullet), so they are derived, not substituted for an existing label. |
| 4.4 | The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. | 🟢 | No emoji present; the ER’s tier emoji and the three “Conflicted” warning markers are stripped as required. |
| 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. | 🟢 | Each section is condensed to the template’s one-page budget; long ER cells (e.g. VO2peak target, 6MWD target) are trimmed rather than carried in full. |
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. | 🟢 | The metadata comment is the first element after <!doctype html> (lines 2-14). |
| 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. | 🟢 | YAML opens at line 3 and closes at line 13; the preamble text sits before the opening delimiter. |
| 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; not surfaced anywhere 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. | 🟢 | All values trimmed and unquoted except duration, which contains a colon and is correctly quoted. |
| 5.5 | The filename of the source ER is stated as “er_filename: [er_filename]” | 🟢 | er_filename: elamipretide_2026-0830-0015_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: 26.7.02, matching this QRS.md. |
| 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: 2026-0830-0144. |
| 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) | 🟢 | 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]” | 🟢 | 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) | 🟢 | Nickname plus version number, no qualifier. |
| 5.12 | The filename of the document is stated as “qrs_filename: [filename of this document]” | 🟢 | qrs_filename matches the actual filename. |
| 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. | 🟢 | As 5.4; frontmatter is clean and consistent. |
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 &) |
🟢 | “Elamipretide for Health & Longevity - Quick Reference Sheet”, ampersand entity-encoded. |
| 6.2 | [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &) |
🟢 | “Elamipretide for Health & Longevity”. |
| 6.3 | [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] | 🟢 | 08/30/2026, matching qrs_creation_date 2026-0830-0144. |
| 6.4 | [header_subline_model] is set to [qrs_creator_ai_fullname] | 🟢 | 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 is the unmodified template subline; no badge, AKA line or version stamp. |
7. At-A-Glance Section
| # | Description | Result | Comments |
|---|---|---|---|
| 7.1 | [at_a_glance] is dense, execution-oriented summary of the ER Conclusion section |
🟢 | Condenses the ER Conclusion (lines 459-463) into an execution-oriented verdict. |
| 7.2 | [at_a_glance] is no longer than 60 words | 🟢 | Exactly 60 words. |
| 7.3 | Every fact in [at_a_glance] is supported by a distinct passage in the ER. | 🟢 | Each of the six facts maps to a distinct ER conclusion passage (first approval / single ultra-rare indication / strongest results outside longevity / three larger trials missed / older-adult gain gone in a week / local injection-site harms). |
| 7.4 | It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead | 🟢 | No acronyms; “mitochondria” is glossed as “cell power plants” in the same sentence. |
| 7.5 | It DOES NOT cite specific trials (names, years, sample sizes, p-values) | 🟢 | No trial names, years or sample sizes. |
| 7.6 | It DOES NOT cite effect sizes, relative risks, or statistical results | 🟢 | No effect sizes or statistics. |
8. Contraindications
| # | Description | Result | Comments |
|---|---|---|---|
| 8.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | Derived from the ER “Populations who should avoid Elamipretide” list inside Key Interactions & Contraindications (ER lines 305-312). |
| 8.2 | [stop_items] represent the Contraindications from the ER | 🟢 | All six ER contraindications are represented, one to one. |
| 8.3 | Individual [stop_items] are formatted as <li></li> | 🟢 | Six discrete <li> elements inside the [stop_items] 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. | 🟢 | Every trailing rationale clause is stripped (e.g. “— an absolute contraindication with no rechallenge”, “because of benzyl alcohol toxicity”, “for whom no dose has been established”). |
| 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). | 🟢 | Qualifiers preserved: “under 2,500 g or under 34 weeks gestational age”, “under 30 kg”, “(eGFR under 30 mL/min)”, “cancer-free for under two years”. |
| 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 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 section is populated, and the ER does identify populations that must avoid the intervention. |
| 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 left empty. |
9. Key Interactions
| # | Description | Result | Comments |
|---|---|---|---|
| 9.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | Derived from the ER interaction bullets (ER lines 289-303). |
| 9.2 | [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications | 🟢 | All five ER bullets that describe an actual interaction or additive effect are carried; the three bullets the ER explicitly labels “no interaction” are correctly excluded, since listing them in a decision gate would contradict item 1.3. |
| 9.3 | Individual [caution_items] are formatted as <li></li> | 🟢 | Five discrete <li> elements inside the [caution_items] 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. | 🟢 | Only the agent class survives; every “— caution, theoretical”, “— additive, effect unquantified” style clause and its rationale is 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). | 🟢 | Named example drug lists preserved verbatim: (cimetidine, dofetilide), (non-steroidal anti-inflammatories, contrast dye, aminoglycosides), (valproate, phenytoin), (prednisone), (tacrolimus), (baclofen), (fexofenadine, cetirizine), (hydrocortisone). |
| 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 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 section is populated, and the ER does identify interactions that change how the intervention is used. |
| 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 left empty. |
10. Protocol
| # | Description | Result | Comments |
|---|---|---|---|
| 10.1 | The section is derived from the ER Protocol section |
🟢 | Derived from the ER Therapeutic Protocol section (ER lines 332-356). |
| 10.2 | The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section |
🟢 | The dose regimen, the timing rule and the condition-driven dose adjustment are the three decision-bearing aspects; the competing-dose and split-dosing bullets are folded into the sub-cells rather than dropped. |
| 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 supplies well over three actionable aspects 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. |
🟢 | All nine action variables carry substantive ER-derived content. |
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 filtration, Barth functional gains and aging-muscle energetics are the three time-to-effect aspects the ER quantifies. |
| 11.2 | The sets are picked and ordered by the magnitude of the related benefit | 🟢 | Ordered Medium tier (kidney oxygenation/filtration) first, then the two Low-tier items in the ER’s own Low-tier order (Barth strength/walking before short-term aging-muscle energetics). |
| 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. | 🟢 | All nine time variables carry substantive ER-derived content. |
| 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, so the row is retained. |
12. Benefits
| # | Description | Result | Comments |
|---|---|---|---|
| 12.1 | The section is derived from the ER Expected Benefits section |
🟢 | Derived from the ER Expected Benefits section (ER lines 141-201). |
| 12.2 | Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] | 🟢 | All four benefit variables present. |
| 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. | 🟢 | Items reduce to the ER tier headings; no magnitudes, mechanisms or study details carried. |
| 12.4 | Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | No parenthetical content present. |
| 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. | 🟢 | The ER records no High-tier benefit, and [benefits_high] is an empty span with style=”display: none” rather than empty-state text. |
13. Risks
| # | Description | Result | Comments |
|---|---|---|---|
| 13.1 | The section is derived from the ER Potential Risks & Side Effects section |
🟢 | Derived from the ER Potential Risks & Side Effects section (ER lines 219-267). |
| 13.2 | Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] | 🟢 | All four risk variables present. |
| 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. | 🟢 | Items reduce to the ER tier headings; no frequencies or mechanisms carried. |
| 13.4 | Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | No parenthetical content present. |
| 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 carry at least one ER item, so no span needed hiding. |
14. Monitoring
| # | Description | Result | Comments |
|---|---|---|---|
| 14.1 | The section is derived from the ER Monitoring section |
🟢 | Derived from the ER Monitoring Protocol & Defining Success section (ER lines 419-431). |
| 14.2 | All measurable/quantifiable biomarkers from the Monitoring section are listed |
🟢 | All seven ER biomarker table rows are present, with targets and rationales matching the ER. |
| 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. |
🟢 | Populated from the ER cadence sentence at ER line 421. |
15. Qualitative Assessment
| # | Description | Result | Comments |
|---|---|---|---|
| 15.1 | The section is derived from the ER Monitoring section |
🟢 | Derived from the ER qualitative marker list (ER lines 433-439). |
| 15.2 | All subjective/qualitative biomarkers from the Monitoring section are listed |
🟢 | All five ER qualitative markers are listed. |
Issues 30/08/2026 02:02
Pass rate 100.00%. No issues found.
Issues 30/08/2026 01:55
- 2.6 / 2.9 — Imperative addresses the reader: [marker_5_target] and [marker_6_target] (lines 706-708 and 724-727) read “track change from own baseline”, a bare second-person imperative; the ER’s own depersonalised wording is “track change from the individual’s own baseline” (ER lines 429-430).
Fixes 30/08/2026 01:55
- 2.6 / 2.9 — Reader-directed imperative removed: [marker_5_target] and [marker_6_target] were changed from “track change from own baseline” to “change from the individual’s own baseline”, restoring the ER’s depersonalised wording so neither target addresses the reader.
Issues 30/08/2026 01:50
- 4.2 / 4.3 — Protocol label abbreviated: [action_3_label] at QRS line 477 reads “Pre-existing conditions”, but the source ER bullet label at ER line 356 is “Pre-existing conditions influencing response:”; the label must be carried over verbatim, not truncated.
Fixes 30/08/2026 01:50
- 4.2 / 4.3 — Protocol label restored verbatim: [action_3_label] changed from “Pre-existing conditions” to “Pre-existing conditions influencing response”, matching the ER bullet label verbatim.