Audit: QRS - Finasteride for Health & Longevity

Audit conducted on 21/08/2026 14:36 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 cells trace to ER lines 348/350/358; time-to-effect to ER line 403; benefit and risk items to the ER `Expected Benefits` and `Potential Risks & Side Effects` headings; gates to ER lines 307-326; monitoring table to ER lines 435-440; cadence to ER lines 429/431; qualitative items to ER lines 444-449.
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 study has shown it extends life” mirrors ER line 469; the ER’s ⚠️ Conflicted markers are carried as “(conflicted)”.
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”).	🟢	All four ER conflicted flags are preserved; contraindications retain their absolute framing.
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 ER `Key Interactions & Contraindications`; no Benefit- or Risk-Modifying Factor appears anywhere in the QRS.
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, expert names or brand names in the QRS; named drugs (ketoconazole, ritonavir, clarithromycin, rifampicin, carbamazepine, doxazosin, tamsulosin, dutasteride) all appear in ER lines 307-317 for the same facts.
1.6	The QRS does not introduce new attributions.	🟢	No attributions of any kind in the QRS.

2. Focus, Tone & Audience

#	Description	Result	Comments
2.1	The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing.	🟢	Neutral, 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	🟢	Quantified targets and tiered evidence strength presented without alarm or exhortation.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Statements are descriptive (“Timing is clinically irrelevant”), not directives to a patient.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperative second-person instruction; content is stated as established practice.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No occurrence of “recommend”, “advise”, or “should” in the QRS body.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No “you”/”your” anywhere in the document.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Retained technical terms (Child-Pugh Class C, CYP3A4, oestradiol) are load-bearing decision-gate or biomarker names taken verbatim from the ER.
2.8	Information is presented in a concise and very compact manner	🟢	Every gate, benefit, and risk item is a single clause; ER trailing explanations are stripped.
2.9	It DOES NOT address the reader directly	🟢	Confirmed — no second-person constructions.
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 biomarker targets and a structured monitoring cadence presuppose a proactive, self-managing 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.	🟢	Indefinite dosing, repeat lab panels and standardised photography 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.	🟢	Tighter-than-conventional functional targets and a six-marker panel are beyond general-population framing.
2.13	Framing, takeaways, and risk/benefit weighting throughout the document reflect this audience, including where an intervention’s signal for the average person differs from its signal for this audience.	🟢	At-A-Glance leads with the longevity-relevant negative (“No study has shown it extends life”), which is the distinguishing signal 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.	🟢	“Anti-aging” does not occur; the page title uses “Health & 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.	🟢	“1 mg orally once daily”, “tablet”, “prostate-specific antigen”; no colloquial substitutes.

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 fifteen fixed strings verified byte-identical against [qrs_template] (lines 437, 474, 516, 553, 572, 603, 536, 542, 519-528, 555-565, 576-578).
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 34 template spans present; the repeatable `marker_#_*` and `qualitative_item_#` patterns are correctly expanded to marker_1-6 and qualitative_item_1-6.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	`<span website="evidence_review">`, `<span website="audit">` and `<span website="full_review">` are unchanged; head/CSS block is byte-identical to the template.

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 into 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.	🟢	All six caution labels and the three protocol labels (“Standard hair-loss protocol”, “Standard prostate protocol”, “Best time of day”) match the ER bold labels verbatim.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Monitoring marker names are ER table names verbatim; time-to-effect cell labels are drawn from the ER’s own wording in line 403.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji code points anywhere in the file; the ER’s tier emojis are dropped in favour of the template’s CSS palette.
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 rather than transcribed: em-dash clauses stripped from gates and qualitative items, severity/mitigation sentences dropped from interactions, magnitudes dropped from benefits and risks.

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 `<!doctype html>` on line 1.
5.2	Inside that HTML comment the YAML block is delimited by a line “—” opening and a line “—” closing. Text before the opening “—” is permitted but is not parsed as YAML.	🟢	Opening `---` on line 3, closing `---` on line 13; the preamble text on line 2 sits before the opener.
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 duplicated in the header or footer.
5.4	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	Only `duration: "00:03"` is quoted, correctly, because it contains a colon.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	Line 4: `er_filename: finasteride_2026-0821-1202_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: `qrs_prompt_version: 26.7.02`, matching the QRS.md version badge.
5.7	Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430)	🟢	Line 6: `qrs_creation_date: 2026-0821-1429`.
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: `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)	🟢	“Opus” — 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: `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]”	🟢	Line 9 matches the file on disk: `finasteride_2026-0821-1202_Opus_QRS.html`.
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: all ten keys have single-space separators and no stray whitespace or quoting.

#	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 `&`)	🟢	Line 22: “Finasteride for Health & Longevity - Quick Reference Sheet”, matching ER `canonical_topic` with the ampersand encoded.
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: “Finasteride for Health & Longevity”.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	Line 421: “08/21/2026”, the correct reformat of 2026-0821-1429.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	Line 425: “Opus 5”.
6.5	No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker.	🟢	Header block (lines 415-428) is structurally identical to the template; the ER’s “Also known as” line is not carried over.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER `Conclusion` section	🟢	Line 433 condenses ER lines 469-471: mechanism, the two established uses, the absent longevity signal, and the two dominant costs.
7.2	[at_a_glance] is no longer than 60 words	🟢	58 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Mechanism → ER line 469 sentence 1; strong evidence for hair and prostate → line 469 sentence 2; no life extension → line 469 final clause; sexual side effects and PSA halving → line 471.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; PSA is rendered as “the blood marker used to screen for prostate cancer” and DHT as “a stronger hormone”.
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	🟢	Only the qualitative “halves”; no ratios, intervals or percentages.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER `Key Interactions & Contraindications` section	🟢	All six items map to the “Populations who should avoid Finasteride” list at ER lines 321-326.
8.2	[stop_items] represent the Contraindications from the ER	🟢	All six ER populations are present, none added.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Lines 542-547: six discrete `<li>` elements inside the span.
8.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	The em-dash clause “— including handling broken or crushed tablets” and the trailing “for whom no dosing data exist” are correctly stripped; leading “Anyone with” / “People with” removed.
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 C)” retained and trimmed of its gloss; “under 18 years” and “unless under close psychiatric supervision” both preserved.
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 contraindication list uses no ranking notation.
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 six 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 six items map to ER lines 307-317.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	All six ER interaction bullets are present; no overlap with the six contraindications.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Lines 555-560: six discrete `<li>` elements inside the span.
9.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	Severity tags, mitigation sentences and mechanistic asides (“Stacking them adds no proven benefit but compounds…”) are all stripped to a single clause per item.
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).	🟢	“(ketoconazole, ritonavir, clarithromycin)” and “(rifampicin, carbamazepine)” preserved verbatim; the alpha-blocker examples are retained as “(doxazosin, tamsulosin)”.
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 interaction bullets use no ranking notation.
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 six 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 map to the ER `Therapeutic Protocol` bullets at lines 348, 350 and 358.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER `Protocol` section	🟢	The two dose regimens (the only two approved indications) plus timing; the remaining ER bullets are commentary, competing approaches, or modifier notes rather than primary actions.
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; 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.	🟢	Nine populated fields, all traceable: “1 mg orally once daily” / “5 mg orally once daily” / “Timing is clinically irrelevant” with subs from ER lines 348, 350 and 358.

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	🟢	Density (6-12 months), shedding (3 months) and prostate symptoms (~6 months) are the three timepoints given in ER line 403.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Hair endpoints first (ER’s leading High benefit, `Preservation and Regrowth of Scalp Hair`), then the prostate endpoint (`Reduced Progression of Benign Prostatic Enlargement`).
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.	🟢	Nine populated fields; the “before regrowth is visible” sub draws on ER line 405 and “as the gland shrinks” on line 403.
11.5	If the ER does not provide any information on time to effect, the section is removed completely from the `Protocol Panel`	N/A	The ER provides time-to-effect data at line 403, so the section is correctly retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER `Expected Benefits` section	🟢	All eight items correspond one-to-one with the ER `Expected Benefits` sub-headings (lines 151-201).
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present and populated at lines 521-532.
12.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢	Each item is the ER sub-heading alone; no Magnitude: figures, trial names or funding notes carried over.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No ER parenthetical survives; “(conflicted)” is the required non-emoji rendering of the ER’s own ⚠️ Conflicted flag, not carried-over parenthetical content.
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 ER benefit tiers contain items.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER `Potential Risks & Side Effects` section	🟢	All ten items correspond one-to-one with the ER sub-headings (lines 225-287).
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present and populated at lines 572-583.
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.	🟢	Each item is the ER sub-heading alone; hazard ratios, NNH and Gleason glosses are all dropped.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No ER parenthetical survives; “(conflicted)” is the required non-emoji rendering of the ER’s own ⚠️ Conflicted flag.
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 ER risk tiers contain items.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER `Monitoring` section	🟢	Rows map to the biomarker table in ER `Monitoring Protocol & Defining Success` (lines 435-440).
14.2	All measurable/quantifiable biomarkers from the `Monitoring` section are listed	🟢	All six ER biomarkers present, with names and functional ranges verbatim: PSA, total testosterone, oestradiol, hemoglobin A1c, LDL cholesterol, ALT.
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.	🟢	Line 669 condenses ER lines 429 and 431, including the six-month PSA anchor.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER `Monitoring` section	🟢	All six items map to the qualitative marker list at ER lines 444-449.
15.2	All subjective/qualitative biomarkers from the `Monitoring` section are listed	🟢	Six of six carried over: scalp photographs, libido and erectile quality, mood, sleep, cognition, and urinary symptoms.

Issues 21/08/2026 14:36

Pass rate 100.00%. No issues found.