Audit: QRS - Kisspeptin-10 for Health & Longevity

Audit conducted on 06/08/2026 14:15 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	91
Passed	81
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

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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.	🟢
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)”; “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”	🟢
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 source ER section that feeds the QRS is empty, so no empty-state phrasing applies.
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., & 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]	🟢
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] is dense, execution-oriented summary of the ER Conclusion section	🟢
7.2	[at_a_glance] is no longer than 60 words	🟢
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢
7.6	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 uses no ranking notation (e.g. “>”) inside parentheses in its contraindication bullets.
8.7	If no [stop_items] are present the section is left empty	N/A	Nine [stop_items] are present.

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 uses no ranking notation (e.g. “>”) inside parentheses in its interaction bullets.
9.7	If no [caution_items] are present the section is left empty	N/A	Twelve [caution_items] are present.

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	Three distinct actionable implementation aspects are present; 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	Three distinct time-to-effect aspects are present; 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 information (Practical Considerations, “Time to effect”).

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 contain 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 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 contain items.

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 06/08/2026 14:15

Pass rate 100.00%. No issues found.

Issues 06/08/2026 14:08

1. 8.5 — eGFR qualifier dropped from CKD item: The ninth contraindication (QRS line 549) reads “chronic kidney disease below 30 mL/min/1.73 m²”, attaching the threshold to the disease rather than to the estimated glomerular filtration rate the ER specifies (ER line 364).

Fixes 06/08/2026 14:08

1. 8.5 — eGFR qualifier restored to CKD item: Changed the ninth contraindication from “chronic kidney disease below 30 mL/min/1.73 m²” to “chronic kidney disease with eGFR below 30 mL/min/1.73 m²”, reattaching the threshold to the measure the ER specifies.

Issues 06/08/2026 14:01

1. 1.3 — Coronary stenosis severity dropped: Contraindication 3 renders the ER’s “untreated significant coronary stenosis” (ER line 359) as “untreated coronary stenosis” (QRS line 544), dropping the severity class and broadening the gate beyond what the ER states.

Fixes 06/08/2026 14:01

1. 1.3 — Coronary stenosis severity restored: Contraindication 3 changed from “untreated coronary stenosis” to “untreated significant coronary stenosis”, restoring the severity class used in the ER.

Issues 06/08/2026 13:53

1. 1.2 — “controlled” dropped from trial caveat: action_2_sub (line 461) reads “no trial has evaluated it”, while the ER (line 397) states “No controlled trial has evaluated this dose, this route, this frequency or these endpoints for kisspeptin-10”; the qualifier that keeps the claim accurate is missing.
2. 1.3 — “unevaluated” dropped from PSA gate: The first stop_items entry (line 542) contraindicates any “prostate-specific antigen above 4.0 ng/mL”, whereas the ER (line 357) restricts this to an “unevaluated” value; the parenthetical “(2.5 under 60)” also drops the “ng/mL” unit and the “in a man” qualifier.

Fixes 06/08/2026 13:53

1. 1.2 — Restored “controlled” trial qualifier: action_2_sub changed from “Commercially derived; no trial has evaluated it.” to “Commercially derived; no controlled trial has evaluated it.”, matching the ER’s cautious phrasing.
2. 1.3 — Restored “unevaluated” on PSA gate: The first contraindication now reads “unevaluated prostate-specific antigen above 4.0 ng/mL (2.5 ng/mL in men under 60)”, reinstating the ER’s qualifier and the missing unit and sex qualifier in the parenthetical.

Issues 06/08/2026 13:44

1. 4.5 — Document renders to roughly 2.5 A4 pages: Modelled against the print stylesheet the sheet measures about 2,530 px of content against the 1,031 px A4 budget; the caution_items gate (lines 557–570) wraps to about 30 lines, 8 of the 15 Monitoring “Why” cells wrap to a second line, and at_a_glance (line 433) runs to five lines.
2. 2.8 — Fields carry multi-sentence prose: action_1_sub, action_2_sub and action_3_sub (lines 450, 461, 472) each run two to three sentences in a one-third-width cell, and time_2_sub (line 500) appends the redundant “This is not a compound with a loading period”.

Fixes 06/08/2026 13:44

1. 4.5 — Overall sheet condensed: Rewrote every variable field for compactness, cutting the modelled render height from about 2,530 px to about 2,000 px against the 1,031 px A4 budget; the residual length is set by items 8.2, 9.2, 14.2 and 15.2, which mandate all 9 contraindications, 12 interactions, 15 biomarkers and 7 qualitative markers.
2. 2.8 — Protocol subs reduced to one sentence: Condensed action_1_sub, action_2_sub and action_3_sub from two and three sentences to one, e.g. action_2_sub from “Subcutaneous injection, frequently combined with growth hormone secretagogues. No controlled trial has evaluated this dose, route, frequency or these endpoints. Commercially derived, not evidence-derived.” to “Subcutaneous, often stacked with growth hormone secretagogues. Commercially derived; no trial has evaluated it.”
3. 2.8 — Redundant time-to-effect sentence removed: Shortened all three time_#_sub fields and dropped “This is not a compound with a loading period” from time_2_sub, taking the second protocol row from three rendered lines per cell to two.
4. 4.5 — At-A-Glance shortened: Trimmed at_a_glance from 60 to 55 words, removing one rendered line.
5. 4.5 — Benefit and risk tiers tightened: Rewrote all eight tier entries in headline form (e.g. “Acute stimulation of luteinizing hormone and follicle-stimulating hormone release” to “Acute luteinizing and follicle-stimulating hormone release”), taking the two cards from 16 rendered lines to 11.
6. 4.5 — Interaction drug lists trimmed: Reduced the parenthetical example agents in caution_items to two or three representatives per class as permitted by item 9.5, taking the gate from about 30 rendered lines to 21.
7. 4.5 — Contraindication wording tightened: Condensed stop_items phrasing from 22 rendered lines to 20 while preserving every threshold, time window and severity class.
8. 4.5 — Monitoring “Why” column reduced to one line per row: Shortened 8 of the 15 “Why” cells, e.g. “Establishes vascular risk before a vasoconstrictive agent” to “Baseline vascular risk”, so every biomarker row now occupies a single line.
9. 4.5 — Cadence and qualitative item shortened: Cut monitoring_cadence from three rendered lines to two and qualitative_item_3 from two lines to one by dropping the trailing study detail.

Issues 06/08/2026 13:31

1. 1.3 — Long-term safety claim broadened: [at_a_glance] (line 433) says “No long-term safety data exist”, while the ER Conclusion (line 538) says “No long-term human safety data exist”; dropping “human” strengthens the claim beyond the ER, which does report long-term-relevant rodent data.

Fixes 06/08/2026 13:31

1. 1.3 — Long-term safety claim restored: [at_a_glance] changed from “No long-term safety data exist” to “No long-term human safety data exist”, matching the ER Conclusion; “sex hormone chain” was hyphenated to “sex-hormone chain” so the section stays within the 60-word limit.