Audit: QRS - Electrical Muscle Stimulation for Muscle Growth
Audit conducted on 13/09/2026 17:41 using AI4L / Opus 5
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. | 🟢 | Protocol values (85 Hz, 350 µs, 6 s/4 s, 20 min, ~50% MVC, 63%), time-to-effect windows, all 10 contraindications, all 9 interactions, all 10 biomarkers and all 6 qualitative markers trace to ER lines 300-311, 282-298, 337-343, 393, 419-441. |
| 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. | 🟢 | No ER hedge is restated in stronger terms; tiered descriptors carry evidence strength via the tier label as section 12/13 prescribe. |
| 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”). | 🟢 | Absolute contraindications stay in the stop gate; the relative pair (malignancy, diabetic neuropathy) retains “(relative; medical clearance required)”. |
| 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 and caution gates draw only from ER Key Interactions & Contraindications; benefits from Expected Benefits; risks from Potential Risks & Side Effects. |
| 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, author names or brand names appear anywhere in the QRS. |
| 1.6 | The QRS does not introduce new attributions. | 🟢 | No attributions present. |
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. | 🟢 | Phrasing is lifted or lightly condensed from the ER throughout. |
| 2.2 | The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging | 🟢 | Lede opens with the established benefit before stating the damage trade-off. |
| 2.3 | The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor | 🟢 | Content is stated as findings and ranges, not instructions. |
| 2.4 | The QRS avoids language that implies medical or clinical advice | 🟢 | No imperatives; the sole clearance reference mirrors the ER’s own relative-contraindication wording. |
| 2.5 | The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” | 🟢 | No “recommended”, “should be used”, or equivalent in the document’s own voice. |
| 2.6 | The QRS never addresses “the reader” directly — it presents evidence, not guidance | 🟢 | No second-person pronouns anywhere in the file. |
| 2.7 | The QRS is written in plain language, avoiding unnecessary medical jargon | 🟢 | Abbreviated markers are spelled out on first use (eGFR, hsTnT, hsCRP, ASMI, CK). |
| 2.8 | Information is presented in a concise and very compact manner | 🟢 | Gate items and tier lines are single clauses; magnitudes and mechanisms are stripped. |
| 2.9 | It DOES NOT address the reader directly | 🟢 | Confirmed; no direct address. |
| 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. | 🟢 | Optimal-range targets and the graded-risk framing address exactly this audience. |
| 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. | 🟢 | Laboratory monitoring and supervised session protocols are presented without hedging about burden. |
| 2.12 | The document is NOT written for the general population, who are unwilling to employ lifestyle and behavioral changes or follow protocols that may be inconvenient, costly, or require effort. | 🟢 | No simplification to 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 sedentary/immobilised/ageing subgroups where the signal is largest and flags the first-weeks hazard. |
| 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. |
| 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. | 🟢 | Formal register maintained (“maximal voluntary contraction”, “rhabdomyolysis”, “appendicular skeletal muscle mass index”). |
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 match the template byte-for-byte (lines 440, 477, 519, 539, 556, 577, 596, 600-602, 726). |
| 3.2 | All “…” from the [qrs_template] are present in the the QRS. | 🟢 | All 34 template variables present; the repeatable rows 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 | 🟢 | Structural diff against the template shows no change outside variable content; the website=”evidence_review”, website=”audit” and website=”full_review” spans and the CSS block are untouched. |
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 mapped to 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. | 🟢 | “Standard whole-body regimen”, “Session frequency”, “Intensity threshold” match ER lines 337, 339, 343 verbatim. |
| 4.3 | Labels are not paraphrased, abbreviated, or invented. | 🟢 | Protocol labels, tier labels and biomarker names are carried unchanged from the ER. |
| 4.4 | The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. | 🟢 | No emoji characters in the file; the ER’s ⭕️/⚠️ flags were dropped 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. | 🟢 | Every gate item, tier line and table cell is reduced to a single clause; list lengths are those mandated 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 the doctype. |
| 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 “—” line 3, closing “—” line 13. |
| 5.3 | The metadata is not visible in any rendered view of the QRS and is not surfaced by any other element on the sheet. | 🟢 | Enclosed in an HTML comment; no element repeats it. |
| 5.4 | All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting. | 🟢 | Only duration: "00:02" is quoted, correctly, because it contains a colon. |
| 5.5 | The filename of the source ER is stated as “er_filename: [er_filename]” | 🟢 | Line 4 names electrical_muscle_stimulation_muscle_2026-0913-1520_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: 26.9.11, matching the QRS.md badge. |
| 5.7 | Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430) | 🟢 | Line 6: 2026-0913-1730. |
| 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” carries no extra qualifier. |
| 5.12 | The filename of the document is stated as “qrs_filename: [filename of this document]” | 🟢 | Line 9 matches 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. |
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 &) |
🟢 | “Electrical Muscle Stimulation for Muscle Growth - Quick Reference Sheet”; no characters require encoding. |
| 6.2 | [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &) |
🟢 | Line 417 matches ER frontmatter canonical_topic exactly. |
| 6.3 | [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] | 🟢 | 2026-0913-1730 → 09/13/2026. |
| 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 holds only title and the template subline. |
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 lines 461-463: efficacy, volume-matched parity, responder groups, absent bone/tendon loading, damage trade-off. |
| 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 clause maps to a distinct sentence of the ER Conclusion. |
| 7.4 | It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead | 🟢 | No acronyms; “severe muscle breakdown” is used in place of rhabdomyolysis. |
| 7.5 | It DOES NOT cite specific trials (names, years, sample sizes, p-values) | 🟢 | No trial identifiers. |
| 7.6 | It DOES NOT cite effect sizes, relative risks, or statistical results | 🟢 | No SMDs, confidence intervals or percentages. |
8. Contraindications
| # | Description | Result | Comments |
|---|---|---|---|
| 8.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | Taken from the “Populations who should avoid” list, ER lines 302-311. |
| 8.2 | [stop_items] represent the Contraindications from the ER | 🟢 | All 10 ER entries are present, in ER order. |
| 8.3 | Individual [stop_items] are formatted as <li></li> | 🟢 | Ten <li> elements, lines 542-551. |
| 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 “— absolute contraindication in German consensus” attributions on epilepsy and arteriosclerosis are stripped; no trailing dash clause remains. |
| 8.5 | Parenthetical qualifiers from the ER bullet — time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely). | 🟢 | eGFR below 30 mL/min/1.73 m², CKD stage 4, 3-month rhabdomyolysis window, CK above 5× upper limit, 160/100 mmHg, 8-week surgical window and the relative/clearance class are all retained. |
| 8.6 | When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol. | N/A | The ER uses no ranking notation in this 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 ER names such populations and the section is populated. |
| 8.8 | If the section is left empty, an HTML comment inside the [stop_items] span records the ER basis for the absence, naming or quoting the ER text relied on. E.g. | N/A | The section is not empty. |
9. Key Interactions
| # | Description | Result | Comments |
|---|---|---|---|
| 9.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | Taken from ER lines 282-298. |
| 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; none duplicates a stop item. |
| 9.3 | Individual [caution_items] are formatted as <li></li> | 🟢 | Nine <li> elements, lines 559-567. |
| 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 are dropped; only the agent class and its qualifier remain. |
| 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 drugs are kept for all four drug classes, and the 48–72 hour window is kept for eccentric training; the “monitor” / “no caution required” classes are retained. |
| 9.6 | When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol. | N/A | The ER uses no ranking notation in these 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 ER names nine such interactions and the section is populated. |
| 9.8 | If the section is left empty, an HTML comment inside the [caution_items] span records the ER basis for the absence, naming or quoting the ER text relied on. E.g. | N/A | The section is not empty. |
10. Protocol
| # | Description | Result | Comments |
|---|---|---|---|
| 10.1 | The section is derived from the ER Protocol section |
🟢 | Drawn from ER Therapeutic Protocol, lines 337-343. |
| 10.2 | The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section |
🟢 | Standard whole-body regimen, session frequency and intensity threshold — the dose, the schedule and the parameter the ER identifies as decisive. |
| 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 provides more than three; 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 fields populated; values (20 min, 85 Hz, 350 µs; 1 session per week; above ~50% MVC) match the ER. |
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 | 🟢 | Muscle size, maximal strength and whole-body lean mass — the three windows given at ER line 393. |
| 11.2 | The sets are picked and ordered by the magnitude of the related benefit | 🟢 | Muscle mass/size (SMD 1.23) precedes maximal strength (SMD 0.98); whole-body lean mass follows as the slowest scan-measured endpoint. |
| 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 provides three distinct aspects; all sets are used. |
| 11.4 | All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER. | 🟢 | 8 weeks, 4 weeks and 12–16 weeks with their ER-sourced qualifiers. |
| 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. |
12. Benefits
| # | Description | Result | Comments |
|---|---|---|---|
| 12.1 | The section is derived from the ER Expected Benefits section |
🟢 | All four tiers map to ER lines 142-200. |
| 12.2 | Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] | 🟢 | All four spans present and populated. |
| 12.3 | Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact. | 🟢 | Each tier is a semicolon-separated list of the ER’s benefit headings only. |
| 12.4 | Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | No SMDs, confidence intervals or study names carried over. |
| 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 have ER content. |
13. Risks
| # | Description | Result | Comments |
|---|---|---|---|
| 13.1 | The section is derived from the ER Potential Risks & Side Effects section |
🟢 | All four tiers map to ER lines 222-262. |
| 13.2 | Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] | 🟢 | All four spans present and populated. |
| 13.3 | Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact. | 🟢 | Only the ER’s risk headings are carried. |
| 13.4 | Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | The 117-fold CK figure and all trial detail are absent. |
| 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 have ER content. |
14. Monitoring
| # | Description | Result | Comments |
|---|---|---|---|
| 14.1 | The section is derived from the ER Monitoring section |
🟢 | Taken from ER Monitoring Protocol & Defining Success, lines 421-432. |
| 14.2 | All measurable/quantifiable biomarkers from the Monitoring section are listed |
🟢 | All 10 ER table rows present with matching optimal ranges and rationales. |
| 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. |
🟢 | Reproduces the ER cadence paragraph at line 419. |
15. Qualitative Assessment
| # | Description | Result | Comments |
|---|---|---|---|
| 15.1 | The section is derived from the ER Monitoring section |
🟢 | Taken from the qualitative-marker list, ER lines 436-441. |
| 15.2 | All subjective/qualitative biomarkers from the Monitoring section are listed |
🟢 | All 6 ER qualitative markers present, in ER order. |
Issues 13/09/2026 17:41
Pass rate 100.00%. No issues found.
Issues 13/09/2026 17:34
- 1.3 — At-a-glance overstates parity scope: Line 433 attaches “roughly matching weight training when training volume is matched” to both lean tissue and maximal strength, whereas the ER Conclusion (line 461) restricts the volume-matched equivalence to strength gains only.
Fixes 13/09/2026 17:34
- 1.3 — At-a-glance parity scope narrowed: Rewrote the [at_a_glance] clause from “roughly matching weight training when training volume is matched” to “with strength gains roughly matching weight training when volume is matched”, restricting the volume-matched equivalence to strength as the ER Conclusion does; the lede remains within the 60-word limit.