Audit: QRS - Ezetimibe to Lower LDL

Audit conducted on 10/08/2026 02:38 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	91
Passed	81
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

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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 spans traced to ER passages: at_a_glance to ER Conclusion; protocol cells to ER Therapeutic Protocol; time cells to ER Practical Considerations and Protocol; benefits/risks tiers to ER headings; gates to ER Key Interactions & Contraindications; markers and cadence to ER Monitoring Protocol & Defining Success.
1.2	Where the ER uses cautious phrasing (“not formally studied”, “None documented in human trials to date”, “theoretical concern”, “data are limited”), the QRS uses the same phrasing.	🟢	The ER’s “⚠️ Conflicted” markers are carried across as “(conflicted)” on all three affected items (primary prevention in older adults, liver fat, bowel cancer signal).
1.3	The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”).	🟢	Contraindications retain absolute framing; “neither has been shown superior on hard endpoints” preserved verbatim in action_3_sub.
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 the ER Key Interactions & Contraindications section; risks only from Potential Risks & Side Effects; no Benefit- or Risk-Modifying Factor migrated.
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 anywhere in the QRS; only generic drug names that appear in the corresponding ER bullets.
1.6	The QRS does not introduce new attributions.	🟢	No attributions of any kind 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.	🟢	Neutral, evidence-first register matching the ER throughout.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Targets and cadence are stated as actionable facts without hedging or alarm.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Statements describe what the evidence shows rather than instructing a patient.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperatives directed at a reader; monitoring cadence is presented descriptively.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No occurrences of “recommend”, “advise”, or “should” addressed to a reader.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the document.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms present are the ER’s own tier-item headings; the At-A-Glance is fully plain-language.
2.8	Information is presented in a concise and very compact manner	🟢	Tier items collapsed to single semicolon-separated lines; protocol subs limited to one or two sentences.
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.	🟢	Functional targets (“many longevity-oriented practitioners target below 50 mg/dL”, ALT below 25 U/L) reflect 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.	🟢	Specialty sterol panel and lifelong daily dosing are presented without dilution.
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.	🟢	Functional ranges are used in preference to conventional reference ranges.
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.	🟢	Lifelong exposure framing and ApoB/Lp(a) monitoring emphasis carry the ER’s longevity-oriented weighting.
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.	🟢	“longevity-oriented practitioners” used; no occurrence of “anti-aging”.
2.15	The document’s own voice uses formal clinical and scientific terminology, not colloquial or consumer-grade language (e.g., “oral medication” not “pill(s)”; “injection” not “shot”; “adverse event” not “bad reaction”). Direct quotes from sources are exempt.	🟢	“oral medication” used in At-A-Glance; “adverse” register maintained; “cheap” mirrors the ER’s own voice (“cheap generic versions”, “one of the cheapest prescription medications”).

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 column headers match the template byte-for-byte.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 38 template variable names present; marker_#* expanded to 9 rows and qualitative_item# to 5 items, giving 66 spans with no omissions.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	A full diff against the template shows changes confined to variable substitutions; CSS, structure, comments, and footer disclaimer 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 relevant 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.	🟢	Protocol labels (“Standard dose and administration”, “Best time of day”, “Combination-first approach”) and all five Qualitative Assessment labels are the ER’s bold labels verbatim.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	No paraphrase or abbreviation of any ER-supplied label; marker names match the ER biomarker table exactly.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji characters present anywhere in the file.
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 section is condensed relative to the ER: benefit and risk tiers reduced to one line each, protocol and time subs to a single sentence, qualitative items trimmed of their trailing rationale.

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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.	🟢	Metadata comment opens at line 2, 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.
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 repeated in the header or 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: "00:05" is quoted, and it contains a colon requiring quoting.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	er_filename: ezetimibe_ldl_2026-0810-0103_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 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: 2026-0810-0228.
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)	🟢	“Opus 5” — nickname plus version, no qualifier.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	qrs_filename: ezetimibe_ldl_2026-0810-0103_Opus_QRS.html, matching the file on disk.
5.13	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	Confirmed 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 &)	🟢	“Ezetimibe to Lower LDL - Quick Reference Sheet”; no characters requiring entity encoding.
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	“Ezetimibe to Lower LDL”, matching the ER canonical_topic.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	2026-0810-0228 rendered as 08/10/2026.
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 contains only the title and the template subline; no AKA line despite the ER carrying alternate_names.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Mechanism, monotherapy versus combination potency, outcome populations, and practical profile — the four movements of the ER Conclusion.
7.2	[at_a_glance] is no longer than 60 words	🟢	57 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Biliary recycling, modest monotherapy effect, event reduction without survival benefit, and low cost all appear in the Conclusion; “once daily” in Motivation and “lifelong” in Discontinuation & Cycling.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	“harmful blood cholesterol” replaces LDL; no acronyms; “statin” is used exactly as the ER Conclusion uses it and is general vocabulary.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial names, years, sample sizes, or p-values.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	Only qualitative magnitude words (“modest”, “substantially more”).

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All five items derive from the ER’s “Populations who should avoid ezetimibe” bullet.
8.2	[stop_items] represent the Contraindications from the ER	🟢	All five ER contraindications present, none added.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Five well-formed <li> elements.
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 trailing rationale (“where exposure rises several-fold with no safety data”, “in whom it is not established outside specialist management”) is stripped; no dashes carry content.
8.5	Parenthetical qualifiers from the ER bullet — time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	“(Child-Pugh Class B or C)” preserved; the “while taking it with a statin” qualifier retained on the transaminase item.
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	If no [stop_items] are present the section is left empty	N/A	Contraindications are present.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All eleven items map one-to-one onto the ER’s eleven interaction bullets, in the ER’s order.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	No overlap with the five contraindications.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Eleven well-formed <li> elements.
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.	🟢	The ER’s “— caution, timing separation”, “— no action needed”, “— additive, monitor” clauses are all 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 lists preserved for sequestrants, fibrates, statins, antacids, and soluble fibers.
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	If no [caution_items] are present the section is left empty	N/A	Key interactions are present.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	All three cells trace to bullets in the ER Therapeutic Protocol section.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Dose, timing, and the combination-first sequencing decision are the three execution-critical bullets.
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 more than three actionable aspects; 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 populated; no placeholders remain.

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	🟢	Onset of LDL reduction, the confirmatory panel window, and pharmacokinetic steady state — all three drawn from the ER “Time to effect” and “Half-life and dose splitting” bullets.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	The primary endpoint (LDL reduction) leads, followed by its confirmation window, then the pharmacokinetic detail.
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 are available 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 spans populated with ER-sourced values (2 weeks, 4–8 weeks, 4–5 days).
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 explicit time-to-effect information.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	All fourteen ER benefit headings appear, none added.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present and populated (5, 4, 3, and 2 items respectively).
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 reduced to the ER heading text; no magnitudes or mechanisms carried over.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No effect sizes or study parentheticals; the only parentheses carry the ER’s “conflicted” evidence marker, required by item 1.2.
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 contain items in the ER.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	All twelve ER risk headings appear, none added.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present and populated (3, 4, 3, and 2 items respectively).
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 reduced to the ER heading text; no frequencies or mechanisms carried over.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No frequencies or severity grades; the only parenthesis carries the ER’s “conflicted” marker on the bowel cancer signal.
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 contain items in the ER.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Marker names, targets, and rationales taken from the ER Monitoring Protocol & Defining Success biomarker table.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All nine ER biomarker rows present: LDL, ApoB, non-HDL, Lp(a), ALT/AST, CK, hs-CRP, fasting glucose/HbA1c, and the sterol panel.
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 cadence paragraph: 4–8 weeks, liver enzymes at 8–12 weeks, then 6–12 months, CK on symptoms, Lp(a) once.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	All items derive from the ER’s “Qualitative markers worth tracking” list.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All five listed: muscle comfort, digestive tolerance, energy and exercise capacity, adherence friction, right upper abdominal discomfort.

Issues 10/08/2026 02:38

Pass rate 100.00%. No issues found.