Audit: QRS - Ibutamoren Mesylate for Health & Longevity

Audit conducted on 22/09/2026 17:56 using AI4L / Opus 5

Iterations

Summary

Items Count
Total 94
Passed 84
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. 🟢  
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. 🟢  
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. 🟢  
1.6 The QRS does not introduce new attributions. 🟢  

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 🟢  
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 🟢  
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. 🟢  
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. 🟢  

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” 🟢  
3.2 All “…” from the [qrs_template] are present in the the QRS. 🟢  
3.3 Spans that are not addressed in a checklist item are left unchanged 🟢  

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 ER section feeding the QRS is empty; no empty-state phrasing required.
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. 🟢  
4.3 Labels are not paraphrased, abbreviated, or invented. 🟢  
4.4 The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. 🟢  
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. 🟢  

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. 🟢  
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. 🟢  
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. 🟢  
5.5 The filename of the source ER is stated as “er_filename: [er_filename]” 🟢  
5.6 Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version 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) 🟢  
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]” 🟢  
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., &amp; for &) 🟢  
6.2 [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., &amp; for &) 🟢  
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢  
6.4 [header_subline_model] is set 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. 🟢  

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 🟢  
7.2 [at_a_glance] is dense, execution-oriented summary of the ER Conclusion section 🟢  
7.3 [at_a_glance] is no longer than 70 words 🟢  
7.4 Every fact in [at_a_glance] is supported by a distinct passage in the ER. 🟢  
7.5 It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead 🟢  
7.6 It DOES NOT cite specific trials (names, years, sample sizes, p-values) 🟢  
7.7 It DOES NOT cite effect sizes, relative risks, or statistical results 🟢  

8. Contraindications

# Description Result Comments
8.1 The section is derived from the ER Key Interactions & Contraindications section 🟢  
8.2 [stop_items] represent the Contraindications from the ER 🟢  
8.3 Individual [stop_items] are formatted as <li></li> 🟢  
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. 🟢  
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). 🟢  
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 inside parentheses.
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. 🟢  
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 (10 contraindications listed).

9. Key Interactions

# Description Result Comments
9.1 The section is derived from the ER Key Interactions & Contraindications section 🟢  
9.2 [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications 🟢  
9.3 Individual [caution_items] are formatted as <li></li> 🟢  
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. 🟢  
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). 🟢  
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 list uses no ranking notation inside parentheses.
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. 🟢  
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 (9 interactions listed).

10. Protocol

# Description Result Comments
10.1 The section is derived from the ER Protocol section 🟢  
10.2 The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section 🟢  
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 Therapeutic Protocol yields three distinct 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. 🟢  

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 🟢  
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢  
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 yields three distinct time-to-effect aspects; 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. 🟢  
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 (Practical Considerations, line 390).

12. Benefits

# Description Result Comments
12.1 The section is derived from the ER Expected Benefits section 🟢  
12.2 Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] 🟢  
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. 🟢  
12.4 Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢  
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 benefit tiers are present in the ER and populated in the QRS.

13. Risks

# Description Result Comments
13.1 The section is derived from the ER Potential Risks & Side Effects section 🟢  
13.2 Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] 🟢  
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. 🟢  
13.4 Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢  
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 risk tiers are present in the ER and populated in the QRS.

14. Monitoring

# Description Result Comments
14.1 The section is derived from the ER Monitoring section 🟢  
14.2 All measurable/quantifiable biomarkers from the Monitoring section are listed 🟢  
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. 🟢  

15. Qualitative Assessment

# Description Result Comments
15.1 The section is derived from the ER Monitoring section 🟢  
15.2 All subjective/qualitative biomarkers from the Monitoring section are listed 🟢  

Issues 22/09/2026 17:56

Pass rate 100.00%. No issues found.

Issues 22/09/2026 17:53

  1. 7.1 — At-A-Glance omits what it is used for: The lede (QRS lines 433-437) names the kind (“an unapproved oral medication”) and the mechanism, but never states what the compound is used for; the ER’s “marketed to people building muscle or hoping to slow physical decline” (ER line 39) has no counterpart, so a reader arriving cold learns what it does but not why anyone takes it.

Fixes 22/09/2026 17:53

  1. 7.1 — At-A-Glance states the use: Rewrote the lede opener to name what the compound is sold for, from “an unapproved oral medication that prompts the body to release more of its own growth hormone” to “an unapproved oral medication, sold to build muscle and slow physical decline, that prompts the body to release more of its own growth hormone”, condensing the following clauses so the section stays within the 70-word limit.

Issues 22/09/2026 17:47

  1. 1.1 / 1.3 — Young-adult claim over-extended: [at_a_glance] (line 434) states “It raises that hormone and the growth factor it controls to young-adult levels for years”, applying the young-adult range to growth hormone as well as to IGF-1; the ER restricts that claim to IGF-1 alone (ER lines 137, 464).

Fixes 22/09/2026 17:47

  1. 1.1 / 1.3 — Young-adult claim over-extended: Rewrote the [at_a_glance] clause from “It raises that hormone and the growth factor it controls to young-adult levels for years” to “It raises that hormone, and for years holds the growth factor it controls at young-adult levels”, restricting the young-adult range to IGF-1 as the ER does. The lede remains within the 70-word limit at 69 words.

Issues 22/09/2026 17:38

  1. 4.5 — Sheet overruns one A4 page: The populated sheet renders to roughly two A4 pages against the template’s single-page print budget, with several spans carrying full ER sentences instead of condensed phrasings — action_1_sub (lines 455–458), action_3_sub (483–486), time_3_sub (530–533), monitoring_cadence (838–842) and the longest stop_items entries (lines 575–578, 583–589, 590).

Fixes 22/09/2026 17:38

  1. 4.5 — Protocol sub-text condensed: Shortened action_1_sub, action_2_sub and action_3_sub to phrase-level summaries (e.g. “The dose used in every pivotal randomized controlled trial and the starting dose recommended in the principal narrative review.” → “Used in every pivotal randomized controlled trial, and the principal narrative review’s starting dose.”), dropping one rendered line from the Protocol row.
  2. 4.5 — Time-to-effect sub-text condensed: Trimmed time_2_sub (“the lean-mass change required 12 months to reach its full extent” → “lean mass needed 12 months for its full extent”) and reordered plus shortened time_3_sub to lead with the early edema and aching, removing one rendered line from the Time-to-effect row.
  3. 4.5 — Contraindication items tightened: Condensed three of the longest stop_items — “Active malignancy, or any cancer treated within the past 5 years” → “Active or prior malignancy within the past 5 years”, the athlete/military entry to a semicolon form, and “open epiphyses (growth plates not yet fused)” → “open growth plates” — cutting two lines from the Contraindications gate while keeping every qualifier.
  4. 4.5 — Monitoring cadence condensed: Merged the duplicated 3–6 month intervals in monitoring_cadence into a single clause, reducing it from 235 to 197 characters without dropping any interval.

Issues 22/09/2026 17:30

  1. 11.4 — Tautological time-to-effect sub: [time_3_sub] at line 531 restates its own label and value (“Appetite and fluid” + “First 2 weeks”) as “Appetite and fluid changes appear in the first two weeks”, contributing no information, while ER lines 219 and 225 offer substantive material on attenuation and on early adverse effects dominating the first months.

Fixes 22/09/2026 17:30

  1. 11.4 — Tautological time-to-effect sub: Replaced [time_3_sub] “Appetite and fluid changes appear in the first two weeks.” with “Appetite typically attenuates over some months but not in everyone; edema and aching dominate the first months of exposure.”, drawn from ER lines 219 and 225, so the cell adds information beyond its own label and value.