Audit: QRS - L-Carnitine for Health & Longevity

Audit conducted on 29/09/2026 04:02 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.	🟢	Lede, protocol, time-to-effect, benefits, gates, risks, markers, cadence and qualitative items all trace to ER passages (Conclusion, Therapeutic Protocol, Practical Considerations, Expected Benefits, Key Interactions & Contraindications, Potential Risks, Monitoring Protocol).
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 phrasing kept: “possible artery risk”, “potential hypothyroid symptoms”, “typically repeated”, “long-term artery safety is 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”).	🟢	No strengthening or softening; qualifiers such as “for high oral doses” and “at supplemental doses beyond dietary intake” retained.
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 come from the ER avoid-list, interactions from the interaction bullets, benefits/risks from their own tiers.
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, study names, NCT numbers, expert names or brand names in the QRS.
1.6	The QRS does not introduce new attributions.	🟢	No attributions introduced.

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 mirrors 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	🟢	Content is presented as ER findings; only the template footer references clinicians.
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 found.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Plain wording; remaining technical terms are ER-standard marker/drug names.
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 or consumer-grade terms (pill, shot, by mouth) found.

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, gate headings, tier labels and column headers match the template.
3.2	All “<span data-qrs-var=”NAME”>…</span>” from the [qrs_template] are present in the the QRS.	🟢	All template spans present; marker_# expanded to 1–11, qualitative_item_# to 1–8.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	website spans, CSS and footer identical to template; only risks_high received 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”	🟢	Only empty ER tier is Risks High, handled via display: none per 13.5; no other empty ER section.
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 “Standard dose”, “Form by goal”, “Single versus split doses” and marker names are verbatim ER labels.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Time-to-effect sub-labels derive directly from the ER “Time to effect” bullet wording.
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.	🟢	Sections are condensed to short descriptors; no content extended beyond condensed form.

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.	🟢	Metadata is inside an HTML comment.
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.	🟢	No stray whitespace; only duration is quoted (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]”	🟢	26.9.28 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)	🟢	2026-0929-0330
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]	🟢	09/29/2026
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: “L-carnitine, a nutrient that carries fat into cellular energy factories, is a dietary supplement taken for metabolic fitness and mental sharpness.”
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	🟢	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	🟢	All five ER avoid-populations listed.
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).	🟢	TSH and eGFR thresholds, taxane time window and dose qualifiers retained.
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	ER uses no ranking notation.
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 avoid-populations.
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	🟢	Taxane interaction excluded as it is a contraindication; OTC “none known” omitted.
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 retained in trimmed form.
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	ER uses no ranking notation.
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. <!– 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	🟢
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 actionable 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	🟢
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Mood (large effect size) precedes the modest weight/metabolic and recovery effects.
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	ER provides four time-to-effect aspects.
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 mirror ER headings; form names kept to identify the benefiting form.
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.	🟢	risks_high span set to 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 11 ER 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 8 ER qualitative markers listed.

Issues 29/09/2026 04:02

Pass rate 100.00%. No issues found.

Issues 29/09/2026 03:55

1. 2.5 — Imperative guidance in monitoring: Monitoring marker_11_target (line 652) reads “No established target; track change from own baseline”, an instruction to the reader rather than presented information.

Fixes 29/09/2026 03:55

1. 2.5 — Imperative guidance in monitoring: Changed marker_11_target from “No established target; track change from own baseline” to “No established target; change from own baseline” so it presents information rather than instructing.

Issues 29/09/2026 03:50

1. 7.2 — Lede omits key chemotherapy harm: The at-a-glance (QRS line 433) cites the acetyl form’s reduced nerve pain but omits the ER Conclusion’s statement that the acetyl form worsened nerve damage during one type of chemotherapy (ER line 505), skewing the execution-relevant risk/benefit summary.

Fixes 29/09/2026 03:50

1. 7.2 — Added chemotherapy harm to lede: Rewrote the at-a-glance final sentence to include that the brain-reaching (acetyl) form worsened nerve damage during certain chemotherapy, and tightened the opening to stay within 70 words.

Issues 29/09/2026 03:47

1. 1.3 / 2.5 — Cadence phrased as directive: The monitoring cadence (line 659) reads “repeat at 8–12 weeks … INR within 1–2 weeks of any change”, dropping the ER’s hedged “are typically repeated” / “is standard” (ER line 460) and using an imperative that instructs rather than presents.

Fixes 29/09/2026 03:47

1. 1.3 / 2.5 — Cadence phrased as directive: Changed the monitoring cadence from “repeat at 8–12 weeks … INR within 1–2 weeks of any change for warfarin users” to “typically repeated at 8–12 weeks … for warfarin users, an INR check within 1–2 weeks of any change is standard”, restoring the ER’s hedged, presentational wording.

Issues 29/09/2026 03:44

1. 11.4 — Time-to-effect sub mismatched: The Exercise recovery cell (QRS line 511) shows “3–5 weeks” but its sub reads “Muscle carnitine loading takes about 24 weeks”, a separate ER time point that contradicts the value instead of describing the ER’s “Exercise-recovery effects appear within 3–5 weeks”.

Fixes 29/09/2026 03:44

1. 11.4 — Time-to-effect sub mismatched: Replaced the Exercise recovery sub “Muscle carnitine loading takes about 24 weeks” with “Exercise-recovery effects appear within this window”, matching the ER’s 3–5 week statement.

Issues 29/09/2026 03:42

1. 11.2 — Time-to-effect order mismatched: The Time to effect row (QRS lines 483–511) leads with “Weight, glucose & lipids”, which the ER calls “modest” (ER lines 154, 503), ahead of Mood, which the ER describes as “a large effect” (ER line 186); the sets are not ordered by magnitude of the related benefit.

Fixes 29/09/2026 03:42

1. 11.2 — Time-to-effect order corrected: Swapped time_1 and time_2 so Mood (4–12 weeks, the ER’s “large effect”) now leads, followed by Weight, glucose & lipids (8–24 weeks) and Exercise recovery.

Issues 29/09/2026 03:38

1. 9.4 — Interaction item lacks key fact: Line 561 “Other interventions (plant-based diets, ketogenic diets, hemodialysis): informational” states only the ER severity tag instead of the key fact (plant-based diets reduce gut TMAO production; ketogenic diets raise carnitine demand; hemodialysis removes carnitine).

Fixes 29/09/2026 03:38

1. 9.4 — Interaction item lacks key fact: Replaced “informational” in the Other interventions item with the ER facts: “lower gut TMAO production, higher carnitine demand, carnitine removal”.

Issues 29/09/2026 03:36

1. 2.7 — Unnecessary jargon in Protocol: action_2_sub (QRS line 461) says “propionyl-L-carnitine 1–2 g/day for claudication”; the Benefits card and the ER heading already use the plain term “leg artery disease”.
2. 9.4 — Mechanism instead of key fact: The thyroid hormone replacement caution item (QRS line 555) reads “antagonizes peripheral thyroid hormone action”, which is the ER’s mechanism, not its key fact (“potentially causing hypothyroid symptoms”). It also reads as if the drug, not carnitine, does the antagonizing.

Fixes 29/09/2026 03:36

1. 2.7 — Replaced claudication jargon: In action_2_sub, changed “for claudication” to “for leg artery disease”, the plain term the ER Benefits heading uses.
2. 9.4 — Thyroid interaction key fact: Changed the thyroid hormone replacement caution item from “antagonizes peripheral thyroid hormone action” to “potential hypothyroid symptoms”, which is the ER’s stated consequence (“potentially causing hypothyroid symptoms”).