Audit: QRS - Ivermectin to Treat Cancer
Audit conducted on 27/09/2026 07:21 using AI4L / Opus 5.5
Summary
| Items | Count |
|---|---|
| Total | 94 |
| Passed | 90 |
| Failed | 0 |
| N/A | 4 |
| 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. | 🟢 | Lede, protocol, time-to-effect, tier items, gates, markers and cadence all trace to ER passages (Conclusion, Therapeutic Protocol, Practical Considerations, Expected Benefits, Potential Risks, Key Interactions, Monitoring) |
| 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. | 🟢 | Hedges kept: “Any benefit would be expected”, “uncontrolled”, “remains unknown” |
| 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 Paul Marik / Independent Medical Alliance, attached to the same regimens as in the ER |
| 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. | 🟢 | 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. | 🟢 | “medication” used in lede; no pill/shot/by-mouth phrasing |
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. | 🟢 | All template spans present; marker_# and qualitative_item_# expanded to numbered spans; time_3 spans retained empty |
| 3.3 | Spans that are not addressed in a checklist item are left unchanged | 🟢 | Diff against template shows changes only in addressed spans |
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” | 🟢 | Empty ER tiers (Medium benefits, High risks) handled via display:none per 12.5/13.5 |
| 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, qualitative and marker labels are 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 file |
| 4.5 | The QRS is designed to render on one A4 page. Any section that has more content in the ER than fits the per-section budget is condensed by the LLM, not extended onto a second page. | 🟢 | Interactions condensed from 14 ER bullets to 10 items |
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. | 🟢 | Only duration quoted (contains 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]” | 🟢 | 26.9.25 matches 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., & for &) |
🟢 | |
| 6.2 | [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &) |
🟢 | |
| 6.3 | [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] | 🟢 | 09/27/2026 from 2026-0927-0706 |
| 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 | 🟢 | Opens “Ivermectin, a long-established medication for parasitic worm infections” |
| 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 | 🟢 | 69 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 | 🟢 | All 7 ER “Populations who should avoid” entries 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. | 🟢 | |
| 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). | 🟢 | 8,000/50,000 thresholds, first trimester, Child-Pugh class C, 15 kg 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. | 🟢 | No ranking notation in ER contraindications |
| 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. | 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 | 🟢 | All 14 ER interaction bullets represented (some merged); contraindication covers only non-stoppable inhibitors |
| 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). | 🟢 | Example drug lists preserved |
| 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. | 🟢 | No ranking notation in ER interactions |
| 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; ER names interactions |
| 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 | 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 |
🟢 | Continuous regimen, pulse dosing, half-life and food |
| 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 | ER provides more than three aspects |
| 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 | 🟢 | ER provides two time-to-effect aspects (tumor control 2–3 months; symptom relief after several doses) |
| 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. | 🟢 | time_3 cell hidden with display: none and left empty |
| 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. | 🟢 | |
| 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. | 🟢 | benefits_medium hidden with display: none |
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. | 🟢 | risks_high hidden with display: none |
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 10 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. |
🟢 |
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 6 ER qualitative markers listed |
Issues 27/09/2026 07:21
Pass rate 100.00%. No issues found.
Issues 27/09/2026 07:17
- 4.2 / 4.3 — Protocol labels not verbatim: action_1_label “Continuous integrative regimen” (line 444) and action_2_label “Pulse dosing” (line 455) drop the parenthetical part of the ER bold labels “Continuous integrative regimen (Paul Marik, Independent Medical Alliance)” and “Pulse dosing (integrative practitioners, summarized by Paul Marik)” (ER lines 305–306); the pulse-dosing attribution is lost entirely.
Fixes 27/09/2026 07:17
- 4.2 / 4.3 — Protocol labels made verbatim: Changed action_1_label from “Continuous integrative regimen” to “Continuous integrative regimen (Paul Marik, Independent Medical Alliance)” (removing the now-redundant “(Paul Marik)” from action_1_sub) and action_2_label from “Pulse dosing” to “Pulse dosing (integrative practitioners, summarized by Paul Marik)”, matching the ER bold labels.
Issues 27/09/2026 07:14
- 1.2 — Cautious target phrasing dropped: The Imaging row target (line 686, marker_8_target) reads “Stable or shrinking lesions versus baseline”, omitting the ER’s “No functional target;” prefix from the Monitoring table.
Fixes 27/09/2026 07:14
- 1.2 — Cautious target phrasing restored: Changed marker_8_target from “Stable or shrinking lesions versus baseline” to “No functional target; stable or shrinking lesions versus baseline”, matching the ER Monitoring table.
Issues 27/09/2026 07:11
- 4.5 — Key Interactions not condensed: The Key Interactions gate (lines 555-570) lists all 14 ER interaction bullets separately, including same-severity, same-mechanism items (CYP3A4 inducers and St. John’s wort; three sedative entries; grapefruit juice and CYP3A4/P-glycoprotein-inhibiting supplements), so the sheet is not condensed toward the one-page A4 budget.
- 9.5 — Parenthetical classes dropped entirely: “Grapefruit juice” (line 563) and “St. John’s wort” (line 565) drop the ER parentheticals “(a CYP3A4 inhibitor)” and “(a CYP3A4 inducer)” entirely instead of keeping them in shortened form.
Fixes 27/09/2026 07:11
- 4.5 — Key Interactions condensed: Merged same-severity, same-mechanism interaction items (St. John’s wort into CYP3A4 inducers; the three sedative entries into one; grapefruit juice with CYP3A4/P-glycoprotein-inhibiting supplements), reducing the gate from 14 to 10 items while keeping all example drug lists.
- 9.5 — Parenthetical classes restored: Grapefruit juice now carries “(a CYP3A4 inhibitor)” and St. John’s wort is listed within the “CYP3A4 inducers (…)” parenthetical, restoring the ER class qualifiers.
Issues 27/09/2026 07:08
- 1.2 — Conditional time-to-effect phrasing dropped: time_1_sub (line 489) states “Any benefit expected in this window; response judged on imaging every 6–12 weeks”, dropping the ER’s conditional “any benefit would be expected” and the attribution of the imaging interval to trials (ER line 344).
- 9.2 — CYP3A4 and P-glycoprotein inhibitor interactions missing: The ER’s Caution-level interactions for strong CYP3A4 inhibitors and P-glycoprotein inhibitors, with their named drugs (ER lines 266–267), are absent; the contraindication only covers inhibitors “that cannot be stopped”.
Fixes 27/09/2026 07:08
- 1.2 — Conditional time-to-effect phrasing restored: Changed time_1_sub from “Any benefit expected in this window; response judged on imaging every 6–12 weeks” to “Any benefit would be expected in this window; trials judge response on imaging every 6–12 weeks”, matching the ER wording.
- 9.2 — Added CYP3A4 and P-glycoprotein inhibitors: Added “Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir)” and “P-glycoprotein inhibitors (verapamil, amiodarone, cyclosporine, quinidine)” to the Key Interactions list.