Audit: QRS - Glutamine to Treat Cancer
Audit conducted on 08/09/2026 04:39 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. | 🟢 | Every cell traces to the ER: protocol cells to Therapeutic Protocol, benefit/risk items to the ER tier headings, gates to Key Interactions & Contraindications, markers and cadence to 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. | 🟢 | Cautious ER wording retained where carried over, e.g. time_3_sub keeps “single positive randomized trial; unreplicated” and marker_9_target keeps “No established target for this purpose” verbatim. |
| 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”). | 🟢 | |
| 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. | 🟢 | |
| 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. | 🟢 | Only telaglenastat and DRP-104 appear; both are named in the ER for the same fact (Glutamine-targeted anticancer agents (telaglenastat, DRP-104): Absolute contraindication). No PMIDs, NCT IDs or author names. |
| 1.6 | The QRS does not introduce new attributions. | 🟢 | No author, expert, or organisation attributions anywhere in the sheet. |
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. | 🟢 | |
| 2.2 | The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging | 🟢 | |
| 2.3 | The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor | 🟢 | |
| 2.4 | The QRS avoids language that implies medical or clinical advice | 🟢 | |
| 2.5 | The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” | 🟢 | |
| 2.6 | The QRS never addresses “the reader” directly — it presents evidence, not guidance | 🟢 | No second-person address anywhere; a full-text scan for you/your/we/our returns nothing. |
| 2.7 | The QRS is written in plain language, avoiding unnecessary medical jargon | 🟢 | |
| 2.8 | Information is presented in a concise and very compact manner | 🟢 | |
| 2.9 | It DOES NOT address the reader directly | 🟢 | Same as 2.6 — the sheet states findings, never instructs a reader. |
| 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. | 🟢 | |
| 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. | 🟢 | |
| 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. | 🟢 | |
| 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. | 🟢 | |
| 2.14 | The document’s own voice frames usage in longevity terms, not “anti-aging” (e.g., “anti-aging clinics”, “anti-aging community”, “anti-aging medicine”). Proper names that contain “anti-aging” (e.g., “American Academy of Anti-Aging Medicine”) are quoted verbatim. | 🟢 | No “anti-aging” phrasing present. |
| 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. | 🟢 |
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 and tier labels are byte-identical to the template: Protocol, Time to effect, Benefits, Risk & Side Effects, Monitoring, Qualitative Assessment, Contraindications, Key Interactions, High/Medium/Low/Speculative, Marker/Target/Why. |
| 3.2 | All <span data-qrs-var="NAME">...</span> from the [qrs_template] are present in the the QRS. |
🟢 | All 67 data-qrs-var spans of the template are present, with marker_#* expanded to nine rows and qualitative_item# to six. |
| 3.3 | Spans that are not addressed in a checklist item are left unchanged | 🟢 | Head, CSS, website=”…” spans, comments and footer disclaimer diff clean against the template; only the page_title text differs, as required by 6.1. |
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 used by the QRS is empty; the ER populates every section the QRS draws on. |
| 4.2 | Where the ER presents a bulleted item as “Label: content”, the QRS uses the ER’s bold label verbatim as the cell or row label. | 🟢 | Protocol cell labels reuse the ER bold labels verbatim: “Standard oral protocol”, “Swish-and-swallow variant”, “Best time of day”. |
| 4.3 | Labels are not paraphrased, abbreviated, or invented. | 🟢 | Monitoring marker names and protocol labels are the ER’s own; time-to-effect labels name the ER outcome domain, which has no ER bold label to copy. |
| 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 tier emoji and the ⚠️ Conflicted markers are 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. | 🟢 | Content is condensed rather than carried over: benefits and risks are reduced to tier headings without magnitudes, gates carry no rationale, and no section is duplicated or extended. |
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 occupies lines 2-14, immediately after <!doctype html> and before any other content. |
| 5.2 | Inside that HTML comment the YAML block is delimited by a line “—” opening and a line “—” closing. Text before the opening “—” is permitted but is not parsed as YAML. | 🟢 | YAML opens at line 3 and closes at line 13; the descriptive text on line 2 precedes the opening marker. |
| 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. | 🟢 | |
| 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. | 🟢 | Values are trimmed; only duration: “00:03” is quoted, which YAML requires because it contains a colon. |
| 5.5 | The filename of the source ER is stated as “er_filename: [er_filename]” | 🟢 | er_filename: glutamine_cancer_2026-0908-0003_Opus_ER.md matches the source ER. |
| 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 matches the version badge of 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: 2026-0908-0427 follows YYYY-MMDD-HHMM. |
| 5.8 | The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]” | 🟢 | |
| 5.9 | The nickname of the AI is just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT) | 🟢 | |
| 5.10 | The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]” | 🟢 | |
| 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) | 🟢 | |
| 5.12 | The filename of the document is stated as “qrs_filename: [filename of this document]” | 🟢 | qrs_filename matches the actual filename of the document. |
| 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. | 🟢 |
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 &) |
🟢 | |
| 6.2 | [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &) |
🟢 | header_topic is “Glutamine to Treat Cancer”, identical to the ER canonical_topic. |
| 6.3 | [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] | 🟢 | header_subline_date 09/08/2026 is qrs_creation_date 2026-0908 in MM/DD/YYYY. |
| 6.4 | [header_subline_model] is set to [qrs_creator_ai_fullname] | 🟢 | header_subline_model is “Opus 5”, equal to qrs_creator_ai_fullname. |
| 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 carries only date, source link, AI4L link and model; no badge, AKA line or audit stamp. |
7. At-A-Glance Section
| # | Description | Result | Comments |
|---|---|---|---|
| 7.1 | [at_a_glance] is dense, execution-oriented summary of the ER Conclusion section |
🟢 | at_a_glance compresses the ER Conclusion: measurable supportive-care benefits, failed neuropathy and cachexia claims, the unresolved tumour-fuel question, and the route split. |
| 7.2 | [at_a_glance] is no longer than 60 words | 🟢 | 59 words. |
| 7.3 | Every fact in [at_a_glance] is supported by a distinct passage in the ER. | 🟢 | Each clause maps to a distinct Conclusion passage (paragraph 1 for the benefits and the failed claims, paragraph 2 for tumour consumption, the risk section for the infusion signals). |
| 7.4 | It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead | 🟢 | Plain-language throughout: “mouth ulceration”, “radiation skin injury”, “taken by mouth”; no acronyms or specialist classifications. |
| 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 | 🟢 | No risk ratios, effect sizes or statistical results. |
8. Contraindications
| # | Description | Result | Comments |
|---|---|---|---|
| 8.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | All seven gate items come from the ER Key Interactions & Contraindications section, Populations who should avoid Glutamine. |
| 8.2 | [stop_items] represent the Contraindications from the ER | 🟢 | All seven ER avoid-populations are represented, one per item, with none added. |
| 8.3 | Individual [stop_items] are formatted as <li></li> |
🟢 | Each item is a separate <li> inside the stop_items span. |
| 8.4 | Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact. | 🟢 | Items carry no rationale, citation or trailing dash clause; each is the bare gate fact. |
| 8.5 | Parenthetical qualifiers from the ER bullet — time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely). | 🟢 | Qualifiers preserved: Child-Pugh Class B or C, eGFR below 30 mL/min/1.73 m2, carrier states, breakthrough seizure in the past 12 months, “on trial or off-label”. |
| 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. |
🟢 | Section is populated, as required, because the ER names seven populations that should avoid glutamine. |
| 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. <!-- empty: ER names no population that should avoid the intervention --> |
N/A | The section is not empty, so no empty-state HTML comment is required. |
9. Key Interactions
| # | Description | Result | Comments |
|---|---|---|---|
| 9.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | All ten items come from the ER Key Interactions & Contraindications bullet list. |
| 9.2 | [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications | 🟢 | All eleven ER interaction bullets appear except Glutamine-targeted anticancer agents, which is correctly carried in Contraindications instead. |
| 9.3 | Individual [caution_items] are formatted as <li></li> |
🟢 | Each item is a separate <li> inside the caution_items span. |
| 9.4 | Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact. | 🟢 | Only the ER bold labels are carried; the Caution/Monitor verdicts and mechanistic sentences are 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). | 🟢 | Example drug lists preserved verbatim: phenytoin/valproate/carbamazepine/levetiracetam, sodium benzoate/sodium phenylacetate, loperamide/bismuth subsalicylate. |
| 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. |
🟢 | Section is populated, as required, because the ER names ten interactions that change how glutamine is used. |
| 9.8 | If the section is left empty, an HTML comment inside the [caution_items] span records the ER basis for the absence, naming or quoting the ER text relied on. E.g. <!-- empty: ER names no interaction that changes how the intervention is used --> |
N/A | The section is not empty, so no empty-state HTML comment is required. |
10. Protocol
| # | Description | Result | Comments |
|---|---|---|---|
| 10.1 | The section is derived from the ER Protocol section |
🟢 | All three cells derive from 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/schedule, the mucosal swish-and-swallow technique and dose timing are the three implementation aspects that determine how the intervention is executed. |
| 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 three or more distinct actionable aspects, so no set is unused. |
| 10.4 | All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section. |
🟢 | All nine action fields carry ER-derived content; no placeholder text remains. |
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 | 🟢 | Mucosal separation by week two to three, six-day later esophagitis onset, and neuropathy severity at six cycles are the only time-anchored effects the ER reports. |
| 11.2 | The sets are picked and ordered by the magnitude of the related benefit | 🟢 | Ordered by benefit tier: mucosal (High), esophagitis (Medium), neuropathy (Low). |
| 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 supplies three distinct time-to-effect aspects, so no set is unused. |
| 11.4 | All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER. | 🟢 | All nine time fields carry ER-derived content, including the ER’s “one to three days before treatment” pre-load detail. |
| 11.5 | If the ER does not provide any information on time to effect, the section is removed completely from the Protocol Panel |
N/A | The ER does provide time-to-effect information, so the section is retained. |
12. Benefits
| # | Description | Result | Comments |
|---|---|---|---|
| 12.1 | The section is derived from the ER Expected Benefits section |
🟢 | All four tiers mirror the ER Expected Benefits tier structure. |
| 12.2 | Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] | 🟢 | benefits_high, benefits_medium, benefits_low and benefits_speculative are all 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. | 🟢 | Items are the ER benefit headings alone; risk ratios, standardized mean differences, trial counts and the ⚠️ Conflicted markers are all dropped. |
| 12.4 | Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | No parenthetical content survives in any benefit item. |
| 12.5 | If no items of a specific sub-section (high, medium, low, speculative) are present the respective <SPAN> 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 at least one ER benefit, so no span needs hiding. |
13. Risks
| # | Description | Result | Comments |
|---|---|---|---|
| 13.1 | The section is derived from the ER Potential Risks & Side Effects section |
🟢 | All four tiers mirror the ER Potential Risks & Side Effects tier structure. |
| 13.2 | Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] | 🟢 | risks_high, risks_medium, risks_low and risks_speculative are all 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. | 🟢 | Items are the ER risk headings alone; incidences, p-values, day counts and manufacturer attributions are dropped. |
| 13.4 | Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | No parenthetical content survives in any risk item. |
| 13.5 | If no items of a specific sub-section (high, medium, low, speculative) are present the respective <SPAN> 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 at least one ER risk, so no span needs hiding. |
14. Monitoring
| # | Description | Result | Comments |
|---|---|---|---|
| 14.1 | The section is derived from the ER Monitoring section |
🟢 | The table reproduces the ER Monitoring Protocol & Defining Success biomarker table. |
| 14.2 | All measurable/quantifiable biomarkers from the Monitoring section are listed |
🟢 | All nine ER biomarkers are present with ER targets and rationale: ammonia, BUN, creatinine/eGFR, ALT and AST, albumin, CRP, absolute lymphocyte count, plasma glutamine, disease-specific tumor marker. |
| 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. |
🟢 | monitoring_cadence reproduces the ER cadence paragraph: baseline, four weeks, before each subsequent cycle, ammonia recheck where indicated, and a single three-month post-treatment check. |
15. Qualitative Assessment
| # | Description | Result | Comments |
|---|---|---|---|
| 15.1 | The section is derived from the ER Monitoring section |
🟢 | The six items come from the ER’s qualitative marker list in Monitoring Protocol & Defining Success. |
| 15.2 | All subjective/qualitative biomarkers from the Monitoring section are listed |
🟢 | All six ER qualitative markers are present and unabridged. |
Issues 08/09/2026 04:39
Pass rate 100.00%. No issues found.
Issues 08/09/2026 04:32
- 2.6 / 2.9 — Imperative phrasing in protocol cell: [action_2_value] “Suspend with sucrose or trehalose” (line 467) and [action_2_sub] “Swish for two minutes, then swallow, to raise uptake by mouth and throat lining” (line 471) use imperative verbs that instruct the reader, whereas every other protocol and time cell presents evidence in participial or noun form.
Fixes 08/09/2026 04:32
- 2.6 / 2.9 — Imperative phrasing in protocol cell: Converted [action_2_value] from “Suspend with sucrose or trehalose” to “Suspended with sucrose or trehalose” and [action_2_sub] from “Swish for two minutes, then swallow, …” to “Swished for two minutes, then swallowed, …”, matching the presentational participial voice used in every other protocol and time cell.