Audit: QRS - Ewingella americana to Treat Cancer

Audit conducted on 16/10/2026 13:11 using AI4L / Opus 5.5

Iterations

Summary

Items	Count
Total	94
Passed	86
Failed	0
N/A	8
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.	🟢	Every cell traced to the ER: protocol labels to the ER Therapeutic Protocol bullets, markers to the ER monitoring table, gates to Key Interactions & Contraindications, lede to Conclusion.
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.	🟢	“(theoretical)” carried on all ten interaction items; “No human protocol exists”, “No human timeline exists”, “Nothing has been measured in a person” all reproduced.
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”).	🟢	Tier placement preserved (all benefits Speculative; risks Low and Speculative only); no hedge upgraded or downgraded.
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.	🟢	No content from Benefit-Modifying Factors or Risk-Modifying Factors appears in the gates; stop items come only from “Populations who should avoid”.
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.	🟢	The QRS carries no PMIDs, NCT numbers, author names or brand names at all.
1.6	The QRS does not introduce new attributions.	🟢	“the authors”, “the mouse study”, “the attenuated-Salmonella trial”, “the one intravenous trial” all appear in the ER for the same facts.

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 restrained, evidence-first register.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Objective and data-driven throughout; the sheet states what is and is not measured without alarm or promotion.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Gate verbs (“avoid during dosing”, “monitor”, “caution”) are the ER’s own interaction verdicts, not sheet-authored instructions.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No sheet-authored recommendation; the footer disclaimer is the template’s.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	All statements are descriptive reports of what the ER records.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronoun anywhere in the sheet.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Plain throughout; the only acronyms (CFU, NYHA) are load-bearing dose and staging units that 8.5 requires be preserved.
2.8	Information is presented in a concise and very compact manner	🟢	Every gate and tier item is reduced to its key fact; trailing rationale 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.	🟢	Framing assumes a reader evaluating an early signal, not a patient receiving instructions.
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.	🟢	Nine-marker monitoring panel and an intensive cadence are presented without hedging on effort.
2.12	The document is NOT written for the general population, who are unwilling to employ lifestyle and behavioral changes or follow protocols that may be inconvenient, costly, or require effort.	🟢	Density and clinical specificity are well above general-population level.
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 closes on unobtainability, the decision-relevant fact for this audience.
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 term “anti-aging” does not occur in the QRS.
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.	🟢	The lede uses “administered intravenously”; route is named formally everywhere (“intravenously”, “injected directly”).

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 headings byte-identical to the template; surviving tier labels “Low” and “Speculative” unmodified.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	Span inventory compared against the template: all fixed-name spans present, and the marker_#_* / qualitative_item_# patterns expanded to 9 and 4 instances.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	The three website="..." spans are untouched and the whole head/CSS block (lines 1–407 of the template) diffs clean against the QRS.

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 whole ER section is empty; the empty benefit/risk tiers are governed by the more specific 12.5 and 13.5, which require display: none rather than empty-state phrasing.
4.2	Where the ER presents a bulleted item as “Label: content”, the QRS uses the ER’s bold label verbatim as the cell or row label.	🟢	Protocol labels verbatim (“Only dosed regimen (preclinical)”, “Single versus split dosing”, “Clearance rather than half-life”); interaction labels carry the ER bold text with only the plain-language glosses trimmed, as 9.5 permits.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	No invented labels; every label traces to an ER bold label or monitoring-table row name.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	Zero emoji codepoints in the file; the ER’s “⚠️ Conflicted” marker was 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 item is condensed to its key fact; the remaining volume is mandated by 14.2 (all nine biomarkers) and 8.2/8.5 (all ten contraindications with qualifiers preserved).

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 --- at line 3, closing --- at line 13; the title text precedes it.
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 metadata value is echoed into the body.
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: "00:04" is quoted, correctly so 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: ewingella_americana_cancer_2026-1011-1020_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: 26.10.15, 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: 2026-1016-1258, correct format.
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 the full name without the version number, with all remaining words joined by hyphens (e.g., Opus, Sonnet, Grok, Gemini-Flash, GPT)	🟢	“Opus 5.5” minus the version is “Opus”; single word, no hyphen needed.
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.
5.11	The full name of the AI consists of the model name (the word or words directly before the version number, leaving out the first if there is more than one, e.g., Claude Opus 5.5 → Opus 5.5), the model version number and the variant (if any) as stated in the system prompt or developer instructions of the creating model, with every word capitalized and without product, effort or pricing names (e.g., Opus X.Y, Sonnet X.Y, Grok X.Y, Gemini X.Y Flash, GPT X.Y)	🟢	“Opus 5.5” — vendor word dropped, capitalized, no product or effort suffix.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	Line 9 matches the file’s own name 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 tooling-added 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., & for &)	🟢	“Ewingella americana to Treat Cancer - Quick Reference Sheet”; no characters requiring encoding.
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	“Ewingella americana to Treat Cancer”, matching the ER frontmatter exactly.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	2026-1016-1258 → “10/16/2026”.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	“Opus 5.5”, matching the frontmatter.
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 template subline only; the ER’s “Also known as” line was correctly not carried over.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] opens by saying what the intervention is — its kind (e.g., dietary supplement, prescription medication, peptide, plant, procedure, practice) — and what it is used for, in plain language, before any verdict on the evidence	🟢	Opens “an ordinary environmental bacterium studied as a living cancer treatment administered intravenously” — kind and purpose before any verdict.
7.2	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Condenses all four Conclusion paragraphs and closes on the execution-decisive fact (the strain cannot be obtained).
7.3	[at_a_glance] is no longer than 70 words	🟢	58 words.
7.4	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Each of the five claims maps to a distinct Conclusion or Motivation passage.
7.5	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; “intravenously” is required by 2.15 rather than a lay substitute.
7.6	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	“One Japanese laboratory” carries no trial name, year or sample size.
7.7	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No numbers of any kind in the lede.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All ten items come from that section’s “Populations who should avoid Ewingella americana” list.
8.2	[stop_items] represent the Contraindications from the ER	🟢	All ten ER bullets represented, none dropped, none added.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Ten <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.	🟢	All trailing clauses stripped, e.g. the ER’s “— all three dose-limiting toxicities … occurred above that size” and “the upper enrolment limit of the one intravenous live-bacterium trial”; no NCT citations carried through.
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).	🟢	“within the previous 4 weeks”, “larger than 8 cm”, “above 74 years”, “class II–IV”, “within 6 months” and the prosthesis and bowel-perforation examples 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 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 ER names ten such populations and the section is correctly 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	🟢	All ten items come from that section’s interaction bullet list.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	Ten of the ER’s eleven interaction bullets carried; the corticosteroid/immunosuppressant bullet is correctly omitted because it is already stop item 2.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Ten <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.	🟢	Every ER bullet’s post-em-dash rationale and NCT citation stripped; only label, drug examples, verdict and “(theoretical)” 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).	🟢	All named example drugs retained on all ten items; only the plain-language glosses (“blood thinners:”, “fever and pain reducers:”) were trimmed.
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 ER names eleven interactions and the section is correctly 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	🟢	All three cells come from the ER Therapeutic Protocol bullets.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Dose, single-versus-split schedule and clearance window are the three actionable bullets; the remaining bullets are comparator doses, provenance and “none established” entries.
10.3	If less that three distinct actionable implementation aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	Three distinct actionable aspects exist 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 cells populated; labels verbatim from the ER bold labels, values and subs traced to 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	🟢	Tumor clearance “within days”, rechallenge resistance “past 60 days”, intratumoral expansion “by 24 hours” — the ER’s three stated timings.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Order mirrors the ER Expected Benefits order: complete regression, durable rechallenge resistance, direct killing.
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 cells populated and traceable to Practical Considerations, Expected Benefits and Mechanism of Action.
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 an explicit “Time to effect” bullet, so the section is correctly retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	The three speculative items are the ER’s three Speculative benefit headings.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans 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.	🟢	Reduced to the three bare headings; the ER’s supporting sentences, comparator claims and citations all dropped.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses remain in the benefits item.
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.	🟢	High, Medium and Low spans are emptied and carry style="display: none"; the ER’s “No benefit reaches High” prose was correctly not carried over.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	Two Low items and four Speculative items match the ER’s headings in that section.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans 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.	🟢	Reduced to bare headings; the ER’s “Magnitude” paragraphs, case counts and citations all dropped.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses remain in either risks item.
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.	🟢	High and Medium spans are emptied and carry style="display: none".

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	All rows come from the ER Monitoring Protocol & Defining Success biomarker table.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All nine ER table rows present as marker_1–marker_9, in ER order, with targets and rationales preserved.
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’s baseline, 24/48/72-hour, daily-72-hour, 1-week, 4-week, 3-month and 6–8-week imaging schedule.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	All four items come from the ER’s “Qualitative markers worth tracking alongside the laboratory values” list.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All four ER qualitative markers present as qualitative_item_1–4.

Issues 16/10/2026 13:11

Pass rate 100.00%. No issues found.

Issues 16/10/2026 13:04

1. 1.3 — Dose hedge dropped: [action_1_value] (line 453) gives “1 × 10⁹ CFU” as an exact figure where the ER (line 282) writes “roughly 1 × 10⁹ colony-forming units”; the same hedge is retained elsewhere in the panel, so its loss here strengthens the claim.
2. 2.8 — Expansion figure printed twice: The “roughly three-thousand-fold between 3 and 24 hours” statistic appears in both [action_3_sub] (lines 485-487) and [time_3_sub] (lines 530-532), spending two of the six protocol cells on a single fact.

Fixes 16/10/2026 13:04

1. 1.3 — Dose hedge restored: [action_1_value] changed from “1 × 10⁹ CFU intravenously, single dose, in mice” to “Roughly 1 × 10⁹ CFU intravenously, single dose, in mice”, matching the ER’s “roughly 1 × 10⁹ colony-forming units”.
2. 2.8 — Duplicate expansion figure removed: [action_3_sub] no longer repeats the three-thousand-fold 3-to-24-hour figure already carried by [time_3_sub]; it now reads “A live organism has no pharmacological half-life. Clearance sets the window for combination timing.”