Audit: QRS - Insoles for Health & Longevity

Audit conducted on 29/09/2026 15:23 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

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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 QRS content traced to ER text (Conclusion, Therapeutic Protocol, Practical Considerations, Key Interactions & Contraindications, Expected Benefits, Potential Risks, Monitoring table).
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 phrasing preserved (e.g., marker_1_target keeps “No established target”; lede keeps “modest and mostly short-lived”).
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”).	🟢	No strengthening or softening detected; lede mirrors ER Conclusion wording on knee arthritis and back pain.
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.	🟢	Contraindications taken from ER “Populations who should avoid Insoles”; interactions from ER interaction bullets; no modifying factors relabeled.
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, citations, expert names, NCT IDs or brand names appear in the QRS.
1.6	The QRS does not introduce new attributions.	🟢	No attributions 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.	🟢	Measured, evidence-weighted tone consistent with the ER.
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”	🟢	Protocol cells mirror ER Therapeutic Protocol descriptions.
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	🟢	Technical terms retained only where they are ER labels, decision-gate conditions or named markers.
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.	🟢	No “anti-aging” wording.
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.	🟢	No colloquial route-of-administration or consumer-grade clinical terms.

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, tier labels and column headers match the template (lines 440, 477, 519, 539, 551, 568, 587-593, 673).
3.2	All “<span data-qrs-var=”NAME”>…</span>” from the [qrs_template] are present in the the QRS.	🟢	Diff against the template shows all spans present; marker_# and qualitative_item_# expanded to numbered spans.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	Only checklist-addressed spans changed; risks_speculative display:none per 13.5.

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”	🟢	ER Speculative risk tier is an empty heading without any empty-state phrasing; QRS hides that tier per 13.5.
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 and Key Interactions labels use ER bold labels verbatim.
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.	🟢	No emoji in the QRS.
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 volume fits one A4 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.	🟢	Metadata comment at line 2, directly after <!doctype html>.
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.	🟢	duration value “00:00” is quoted because it contains a colon.
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]”	🟢	26.9.29 matches QRS.md version.
5.7	Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430)	🟢	2026-0929-1457
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)	🟢	Opus
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)	🟢	Opus 5.5
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., & for &)	🟢	Line 22: “Insoles for Health & Longevity - Quick Reference Sheet”.
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.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	Line 421: 09/29/2026.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	Line 425: Opus 5.5.
6.5	No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker.	🟢

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 with “Insoles, removable shoe inserts cushioning or supporting the foot” before any verdict.
7.2	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Condenses ER Conclusion paragraphs 1-3.
7.3	[at_a_glance] is no longer than 70 words	🟢	70 words (script count).
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	🟢	No acronyms; plain terms (kneecap, inner-knee arthritis, numb feet).
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	🟢	All five ER “Populations who should avoid Insoles” items present.
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.	🟢	Trailing explanations (e.g., “which requires immobilization”) stripped.
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).	🟢	Thresholds preserved: 2 °C, ABI below 0.5 or rest pain, TUG 13.5 seconds or more, valgus (knock-knee).
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	No ranking notation in the ER bullets.
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 populated; ER names populations to avoid.
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	Section not empty.

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	🟢	Five actionable ER interactions listed; Supplements bullet (no interaction identified) correctly excluded.
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.	🟢	Mitigation clauses 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 (paclitaxel, oxaliplatin, vincristine; warfarin, apixaban; prednisone; ibuprofen, naproxen, acetaminophen).
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	No ranking notation in the ER bullets.
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 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. <!– empty: ER names no interaction that changes how the intervention is used –>	N/A	Section not empty.

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	🟢	Prefabricated-first approach, Diabetic high-risk feet and Patellofemoral pain regimen are key actionable ER protocol items.
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 aspects exist in the ER.
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	🟢	Pressure redistribution (immediate), heel pain (7-12 weeks), kneecap pain (about 6 weeks) from ER Practical Considerations.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Ordered High (diabetic ulcers), High (foot pain), Medium (patellofemoral pain).
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	At least three aspects exist in the ER.
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	ER provides time-to-effect information.

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.	🟢	Items use ER benefit headings without effect sizes or citations.
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 <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 benefit tiers have items.

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 <SPAN> is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	🟢	ER Speculative risk tier is empty; risks_speculative span set to display: none (line 579).

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	🟢	All six ER table biomarkers 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.	🟢	Cadence matches ER Monitoring paragraph.

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	🟢	All six ER qualitative markers listed verbatim.

Issues 29/09/2026 15:23

Pass rate 100.00%. No issues found.

Issues 29/09/2026 15:20

1. 2.13 / 7.2 — Missing Conclusion bottom line: [at_a_glance] (QRS line 433) omits the ER Conclusion’s audience-specific verdict that insoles are “a targeted tool for specific foot, knee and diabetic problems rather than a general longevity measure” (ER line 402).

Fixes 29/09/2026 15:20

1. 2.13 / 7.2 — Added Conclusion bottom line: Rewrote [at_a_glance] to open with the ER Conclusion’s verdict that insoles are “a targeted tool for specific foot, knee and diabetic problems, not a general longevity measure”, tightening the remaining sentences to stay within 70 words.

Issues 29/09/2026 15:18

1. 2.7 — Unexplained technical jargon: “reduced running economy” (risks_high, line 571), “Active plantar ulcer” (stop_items, line 542) and “sham devices” (time_2_sub, line 500) use specialist terms where plain-language equivalents from the ER exist (“energy cost for runners”, “sole of the foot”, “placebo-like”).

Fixes 29/09/2026 15:18

1. 2.7 — Unexplained technical jargon replaced: Changed “reduced running economy” to “higher energy cost of running” (risks_high), “Active plantar ulcer” to “Active ulcer on the sole of the foot” (stop_items), and “sham devices” to “placebo-like devices” (time_2_sub).

Issues 29/09/2026 15:14

1. 7.2 — At-a-glance omits downsides: The at_a_glance text (QRS line 433) summarizes only the ER Conclusion’s benefits and closing verdict; it omits the downsides paragraph (rubbing, blisters, discomfort; poorer standing balance with very soft cushioning) and the lack of reliable benefit for inner-knee arthritis and back pain.

Fixes 29/09/2026 15:14

1. 7.2 — At-a-glance omits downsides: Rewrote the at_a_glance text (68 words) to add the ER Conclusion’s downsides (blisters, discomfort, poorer standing balance with very soft cushioning) and the lack of reliable benefit over flat insoles for inner-knee arthritis and back pain. To stay within 70 words, removed the off-the-shelf versus custom clause (still shown in the Protocol panel) and the closing verdict sentence.

Issues 29/09/2026 15:10

1. 2.7 — Unexplained jargon in tiers: Benefits and Risks use specialist terms where the ER gives plain equivalents: “patellofemoral pain” (line 525; ER “kneecap pain”), “medial knee osteoarthritis pain” (line 528; ER “inner-knee arthritis”), “Intrinsic foot muscle deconditioning” (line 577; ER “small muscles inside the foot”).

Fixes 29/09/2026 15:10

1. 2.7 — Plain-language tier wording: Replaced “patellofemoral pain” with “kneecap pain” (Benefits Medium), “medial knee osteoarthritis pain” with “inner-knee arthritis pain” (Benefits Low), and “Intrinsic foot muscle deconditioning” with “Weakening of the small muscles inside the foot” (Risks Low), all using the ER’s own plain wording.

Issues 29/09/2026 15:08

1. 1.1 — Time to effect overstated: time_3_value (line 508) reads “About 6 weeks”, while the ER Practical Considerations (line 345) says patellofemoral pain relief appears “within about 6 weeks”, turning an upper bound into a point estimate.

Fixes 29/09/2026 15:08

1. 1.1 — Time to effect overstated: Changed time_3_value from “About 6 weeks” to “Within about 6 weeks” to match the ER Practical Considerations wording.

Issues 29/09/2026 15:05

1. 1.1 — Protocol sub broadens ER bullet: Line 450 action_1_sub says the Prefabricated-first approach reserves custom devices for “deformity, rheumatoid feet or failure”, but the ER Prefabricated-first bullet says only “deformity or failure”; “rheumatoid feet” comes from the separate Custom functional orthoses bullet.
2. 4.2 / 4.3 — Interaction labels paraphrased: Lines 555-558 replace or restructure the ER bold labels “Anticoagulants and corticosteroids”, “Over-the-counter medications” and “Footwear” with “Anticoagulants (…) and long-term oral corticosteroids (…)”, “Regular analgesics” and “Shallow or narrow footwear”.

Fixes 29/09/2026 15:05

1. 1.1 — Protocol sub aligned to ER: Changed action_1_sub from “Custom devices reserved for deformity, rheumatoid feet or failure” to “Custom devices reserved for deformity or failure”, matching the ER Prefabricated-first bullet.
2. 4.2 / 4.3 — Interaction labels made verbatim: Rewrote caution items to lead with the ER bold labels: “Anticoagulants and corticosteroids (warfarin, apixaban; long-term oral prednisone)”, “Over-the-counter medications (regular analgesics: ibuprofen, naproxen, acetaminophen)” and “Footwear (shallow or narrow shoes)”.

Issues 29/09/2026 15:02

1. 1.1 / 1.3 — Heel-pain sham window strengthened: time_2_sub (QRS line 500) reads “Benefit over sham devices mainly in this window”, whereas the ER states orthoses outperformed sham devices “only at 7–12 weeks” (ER lines 108, 162), so the QRS implies sham-controlled benefit outside the window.

Fixes 29/09/2026 15:02

1. 1.1 / 1.3 — Heel-pain sham window wording: Changed time_2_sub from “Benefit over sham devices mainly in this window” to “Benefit over sham devices only in this window” to match the ER.

Issues 29/09/2026 14:59

1. 1.2 / 1.3 — Cautious target qualifier dropped: Monitoring marker_1_target (line 602) reads “0–2, or a drop of at least 2 points from baseline”, omitting the ER’s “No established target; aim for…” (ER line 368), which presents the value as an established target.
2. 4.2 / 4.3 — Invented Protocol cell labels: Protocol labels “Device choice”, “Wear time” and “Pain regimens” (lines 444, 455, 466) are invented instead of the ER Therapeutic Protocol bold labels (e.g., “Prefabricated-first approach”, “Diabetic high-risk feet”, “Patellofemoral pain regimen”); “Pain regimens” also merges two separate ER bullets.

Fixes 29/09/2026 14:59

1. 1.2 / 1.3 — Restored cautious target qualifier: Changed marker_1_target from “0–2, or a drop of at least 2 points from baseline” to “No established target; aim for 0–2, or a drop of at least 2 points from baseline”, matching the ER Monitoring table.
2. 4.2 / 4.3 — Protocol labels from ER: Replaced invented labels “Device choice”, “Wear time” and “Pain regimens” with the ER bold labels “Prefabricated-first approach”, “Diabetic high-risk feet” and “Patellofemoral pain regimen”, and realigned each value/sub to that single ER bullet (e.g., “About 6 weeks” / “Prefabricated orthoses fitted for comfort, with exercise therapy as the core”).