Audit: QRS - L-Methylfolate for Health & Longevity

Audit conducted on 22/10/2026 23:33 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, gates, tiers, markers and cadence all trace to ER text (Conclusion, Therapeutic Protocol, Practical Considerations, 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.	🟢	Theoretical qualifiers carried through (e.g., trimethoprim, nitrous oxide, acid-reducing drugs, heavy alcohol “theoretical for L-methylfolate”); “is common” kept for timing.
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 found; lede keeps “modest”, “low-quality evidence”, “possibly promoting”, “remain unproven”.
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.	🟢	Modifying factors are not surfaced as risks or cautions; gates come from Key Interactions & Contraindications.
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, NCT IDs, expert or brand names appear.
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	🟢	Items are stated as evidence-derived facts (“is common”, “monitor”).
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 direct address found.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Remaining technical terms (SSRIs and SNRIs, 5-HTP, MMA, MCV, PHQ-9, 6R isomer) are ER labels or marker names carried verbatim.
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.	🟢	Lede contrasts secured folate status with unproven longevity claims, matching the ER Conclusion.
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 adverse-event wording 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 “…” from the [qrs_template] are present in the the QRS.	🟢	Diff against template: all spans present; marker_# and qualitative_item_# expanded to numbered rows.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	Only metadata values and variable span contents differ from the template.

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 risk tiers (High, Medium) are handled by 13.5 (display: none); no other empty source 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 (“Folate-status dose”, “Depression add-on”, “Time of day”) and interaction labels use ER bold labels, with only glosses and example names trimmed.
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 found in the QRS.
4.5	The QRS is designed to render on one A4 page: every section is condensed to the shortest form the other checklist items allow, not extended onto a second page.	🟢	Content is condensed; long gate lists are required by 8.2 / 9.2.

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 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]”	🟢	26.10.18 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)	🟢	2026-1022-2310
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 the full name without the version number, with all remaining words joined by hyphens (e.g., Opus, Sonnet, Grok, Gemini-Flash, GPT)	🟢	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 model name (the word or words directly before the version number, leaving out the first if there is more than one, e.g., Claude Opus 5.5 → Opus 5.5), the model version number and the variant (if any) as stated in the system prompt or developer instructions of the creating model, with every word capitalized and without product, effort or pricing names (e.g., Opus X.Y, Sonnet X.Y, Grok X.Y, Gemini X.Y Flash, GPT X.Y)	🟢	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 &)	🟢	“L-Methylfolate 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 &)	🟢
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	10/22/2026
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	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 “a dietary supplement supplying ready-to-use vitamin B9, is used to secure folate status”.
7.2	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Condenses the three Conclusion paragraphs.
7.3	[at_a_glance] is no longer than 70 words	🟢	70 words (counted with wc).
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	🟢	Plain terms used (“add-on”, “bowel polyps”, “hiding vitamin B12 deficiency”).
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 four ER “Populations who should avoid” bullets represented.
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.	🟢	Rationale and citations 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).	🟢	B12/MMA thresholds, “until B12 is corrected”, oncologist exception and 15 mg/day kept.
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 avoiding 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.	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 15 ER interaction bullets represented; pemetrexed/pralatrexate (already a contraindication) trimmed from the chemotherapy examples.
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.	🟢	Consequence/Mitigation clauses and citations 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).	🟢	Each parenthetical example list keeps at least one ER example; theoretical qualifiers kept.
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.	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	🟢	Folate-status dose, depression add-on dose, time of day.
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 aspects available.
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	🟢	RBC folate, plasma folate and depression response, the three ER time-to-effect statements.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Folate status (High) before depression (Medium).
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 aspects available.
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.	🟢	ER headings used without flags or qualifiers.
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 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.	🟢	“(Agitation or Mania)” stripped from mood activation.
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 and risks_medium 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 five 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 Protocol text.

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.

Issues 22/10/2026 23:33

Pass rate 100.00%. No issues found.

Issues 22/10/2026 23:30

1. 1.2 — Folic-acid basis of polyp risk dropped: At a Glance (line 433) states “possibly promoting existing bowel polyps” but omits the ER Conclusion’s cautious qualifier “based on folic acid data” (ER line 468).
2. 4.5 — Repetitive time-to-effect sub-line: time_2_sub “Plateaus by about 12 weeks” (line 500) merely repeats time_2_value “About 12 weeks” (line 497).

Fixes 22/10/2026 23:30

1. 1.2 — Restored folic-acid data qualifier: At a Glance now reads “based on folic acid data, possibly promoting existing bowel polyps”; wording elsewhere in the lede was tightened to stay within 70 words.
2. 4.5 — Removed repetitive sub-line: time_2_sub changed from “Plateaus by about 12 weeks” to “Plateaus earlier than red blood cell folate”.

Issues 22/10/2026 23:25

1. 1.1 / 11.4 — RBC folate time misstated: Time to effect cell 1 (QRS line 486) gives red blood cell folate a value of “24+ weeks”, but the ER says it “rises slowly over 12–24+ weeks” (ER line 434) with a clear rise at 12 weeks (ER line 162); “24+ weeks” only restates the not-yet-plateaued finding.

Fixes 22/10/2026 23:25

1. 1.1 / 11.4 — RBC folate time corrected: Changed time_1_value from “24+ weeks” to “12–24+ weeks” and time_1_sub to “Rises slowly; had not plateaued by 24 weeks”, matching ER lines 408 and 434.

Issues 22/10/2026 23:22

1. 1.2 — Timing hedge dropped: action_3_value (QRS line 469) says “Morning or with the antidepressant” without the ER hedge “is common; absorption does not depend on timing” (ER line 374), so a common habit reads as a protocol requirement.

Fixes 22/10/2026 23:22

1. 1.2 — Timing hedge restored: Changed action_3_value from “Morning or with the antidepressant” to “Morning or with the antidepressant is common” and action_3_sub to “Absorption does not depend on timing; food not required”, matching the ER wording.

Issues 22/10/2026 23:20

1. 2.7 — Unglossed jargon in protocol: action_1_sub uses “[6S]-5-MTHF” (line 450) and action_2_sub uses “With an SSRI” (line 461), specialist notation outside any ER label.
2. 9.2 / 4.5 — Pemetrexed duplicated across gates: Pemetrexed is a Contraindication (line 543) and is repeated as an example in the “Antifolate and fluoropyrimidine chemotherapy” interaction (line 556).
3. 9.4 / 4.5 — Mechanistic clause in interaction: The heavy alcohol intake item keeps the rationale “impairs folate absorption and metabolism” (line 567) instead of the key fact plus qualifier.

Fixes 22/10/2026 23:20

1. 2.7 — Plain-language protocol subs: Changed action_1_sub “[6S]-5-MTHF” to “Natural (6S) form” and action_2_sub “With an SSRI” to “With an SSRI antidepressant”.
2. 9.2 / 4.5 — Removed duplicated pemetrexed: Dropped pemetrexed from the “Antifolate and fluoropyrimidine chemotherapy” example list, keeping 5-fluorouracil and capecitabine, since pemetrexed is already a Contraindication.
3. 9.4 / 4.5 — Stripped mechanistic clause: Heavy alcohol intake item changed from “monitor; impairs folate absorption and metabolism (theoretical for L-methylfolate)” to “monitor (theoretical for L-methylfolate)”.

Issues 22/10/2026 23:15

1. 1.3 / 7.2 — Second main risk omitted: At a Glance (line 433) states “Its main risk is hiding a vitamin B12 deficiency”, while the ER Conclusion names two main risks, B12 masking and (based on folic acid data) a possible effect on existing bowel polyps; the risk profile is softened and the Conclusion summary is incomplete.

Fixes 22/10/2026 23:15

1. 1.3 / 7.2 — Second main risk restored: Changed the At a Glance closing sentence from “Its main risk is hiding a vitamin B12 deficiency” to “Main risks are hiding a vitamin B12 deficiency and possibly promoting existing bowel polyps”, matching the ER Conclusion and staying within 70 words.