Audit: QRS - Lithium for Health & Longevity

Audit conducted on 08/08/2026 04:36 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	91
Passed	83
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.	🟢	Every span traced to an ER passage: protocol cells to ER Therapeutic Protocol, gates to Key Interactions & Contraindications, tiers to the ER benefit/risk headings, markers to the ER biomarker 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.	🟢	At-a-glance keeps “unstudied over decades” for the ER’s “nobody has watched anyone take them for thirty years”; speculative tiers retain the ER’s uncertainty framing.
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”).	🟢	Contraindications remain contraindications; interactions remain interactions; no hedge is removed or added.
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.	🟢	No content from Benefit-Modifying Factors or Risk-Modifying Factors appears in the gates or risk 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, author names, NCT identifiers, or brand names appear anywhere in the QRS.
1.6	The QRS does not introduce new attributions.	🟢	No attributions of any kind are present.

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, sceptical register of the ER Conclusion is carried through at-a-glance and the tier lists.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Numeric targets and ranges throughout; framing is informative rather than discouraging.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	No imperatives; protocol cells describe approaches rather than instruct.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	Monitoring and qualitative rows state what a marker detects, not what to do.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No occurrence of “recommend”, “advise”, “should”, or “must” in the document voice.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the rendered content.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Terminology is limited to the marker and condition names the ER itself uses.
2.8	Information is presented in a concise and very compact manner	🟢	All spans are single clauses or short phrases; no sentence pairs outside the cadence note.
2.9	It DOES NOT address the reader directly	🟢	Confirmed by scan for “you”/”your”; none present.
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.	🟢	Trace-dose and sub-therapeutic prescription protocols are surfaced first, matching this audience.
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.	🟢	Fourteen-marker monitoring panel and prescriber-dependent titration are presented without softening.
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.	🟢	Content assumes willingness to obtain serial laboratory panels and a prescriber.
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.	🟢	At-a-glance explicitly separates the firmly established prescription-strength benefit from the unsettled longevity claims.
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.	🟢	“Anti-aging” does not occur; the header uses “Health & Longevity”.
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.	🟢	Uses “estimated glomerular filtration rate”, “urinary concentrating ability”, “hyperparathyroidism”; no consumer-grade substitutes.

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 fourteen fixed strings verified byte-identical to the template.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 34 template variables present; repeatable marker_#_* and qualitative_item_# expanded to 14 and 6 instances.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	Diff against the template shows the website="evidence_review", website="audit", and website="full_review" spans and all CSS untouched.

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.
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.	🟢	“Trace-dose protocol”, “Sub-therapeutic prescription protocol”, “Time of day” and all six qualitative labels are the ER’s bold labels verbatim.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Marker names match the ER biomarker table exactly; protocol and qualitative labels match ER bold labels.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	Scan for emoji code points returns nothing; the ER’s ⚠️ Conflicted markers were correctly dropped.
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.	🟢	Every span is reduced to its minimum key fact; remaining length is driven by items 8.2, 9.2, 14.2, and 15.2, which mandate completeness.

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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.	🟢	Comment opens at line 2, immediately after the doctype.
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.	🟢	Opening “—” at line 3, closing at line 13; the preceding title text is outside the block.
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.	🟢	Enclosed in an HTML comment; no duplicate of these values appears in the body.
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: "00:02" is quoted, correctly, because it contains a colon.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	Line 4: er_filename: lithium_2026-0808-0058_Opus_ER.md.
5.6	Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]”	🟢	Line 5: qrs_prompt_version: 26.7.02, matching the QRS.md version badge.
5.7	Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430)	🟢	Line 6: qrs_creation_date: 2026-0808-0425.
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢	Line 7: qrs_creator_ai_nickname: Opus.
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” — single word, no version.
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢	Line 8: qrs_creator_ai_fullname: Opus 5.
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” — nickname plus version, no qualifier.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	Line 9 matches the file on disk: lithium_2026-0808-0058_Opus_QRS.html.
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.	🟢	Re-verified across all nine keys; no stray whitespace or unnecessary 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 &)	🟢	“Lithium 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 &)	🟢	“Lithium for Health & Longevity”, matching ER frontmatter canonical_topic.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	2026-0808-0425 → 08/08/2026.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	“Opus 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.	🟢	Header is template-identical; the ER’s “Also known as” line was not carried over.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Three sentences mapping directly onto the ER Conclusion paragraphs on established benefit, unsettled wider claims, and the harm profile.
7.2	[at_a_glance] is no longer than 60 words	🟢	59 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Each clause traces to a distinct sentence of the ER Conclusion.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	Plain terms throughout: “prescription strength”, “memory loss”, “thyroid, kidneys, and calcium”, “over-the-counter amounts”.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial name, year, or sample size appears.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No numeric result of any kind.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All ten items come from the ER “Populations who should avoid lithium” bullet.
8.2	[stop_items] represent the Contraindications from the ER	🟢	All ten ER contraindications are present, in ER order.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Ten discrete <li> elements inside the span.
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.	🟢	Explanatory tails such as “when cardiac formation occurs” and the sick sinus syndrome definition were stripped; no dash-trailing clauses remain.
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).	🟢	Retains “(30 to 59: specialist dose reduction and close monitoring)”, “(weeks 2–8 of gestation)”, “above 2.60 mmol/L”, “(New York Heart Association Class III–IV)”, “below about 2 g of sodium daily”.
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.	🟢	The ER uses no such ranking notation in this section; the eGFR band was normalised to “30 to 59” rather than a bare symbol.
8.7	If no [stop_items] are present the section is left empty	N/A	Ten contraindications are present.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All thirteen items map one-to-one to the ER’s thirteen interaction bullets.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	No overlap with the Contraindications gate.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Thirteen discrete <li> elements inside the span.
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.	🟢	The ER’s “— caution, monitor”, “— generally avoid”, “— additive effect” tails are all 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).	🟢	All example drug lists preserved verbatim, including the five-drug serotonergic list and the four-item supplement list.
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.	🟢	The ER uses plain comma-separated drug lists; nothing required normalisation.
9.7	If no [caution_items] are present the section is left empty	N/A	Thirteen interactions are present.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	All three cells derive from the ER Therapeutic Protocol bullets.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	The two dosing routes actually available to this audience plus timing — the three decision points the ER itself foregrounds.
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	The ER supplies more than three; 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.	🟢	“1–5 mg elemental daily”, “150–300 mg carbonate daily”, “Evening, once daily” with subs all traced to ER lines on the trace-dose, sub-therapeutic, and time-of-day bullets.

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	🟢	Mood stabilization, cognitive endpoints, and population benefit — the three timescales named in the ER “Time to effect” bullet.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Order tracks the benefit tiers: mood (High), cognition (Medium), population/mortality (Low).
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 aspects are present in the ER; 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.	🟢	“1–3 weeks”, “12–24 months”, “Decades” with subs all drawn from the ER Practical Considerations time-to-effect bullet.
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; the section is correctly retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	All ten entries correspond to the ten ER benefit headings.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans populated and tiered as in the ER.
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.	🟢	Each entry is the ER heading reduced to a noun phrase; no magnitudes carried over.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any benefit tier.
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	🟢	All seventeen entries correspond to the seventeen ER risk headings.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans populated and tiered as in the ER.
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.	🟢	Each entry is the ER heading reduced to a noun phrase; odds ratios and frequencies omitted.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any risk tier.
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	🟢	All rows drawn from the ER Monitoring Protocol & Defining Success biomarker table.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All 14 ER biomarkers present, in ER order, from serum lithium through neurofilament light chain.
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.	🟢	Both cadences carried over: prescription-dose schedule and the 12-monthly trace-dose schedule with escalation to 6-monthly on drift.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	All six items come from the ER’s qualitative-marker bullets.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All six present: mental sharpness and word-finding, tremor, thirst and urine volume, energy/mood/cold tolerance, sleep quality and timing, gastrointestinal tolerance.

Issues 08/08/2026 04:36

Pass rate 100.00%. No issues found.

Issues 08/08/2026 04:32

1. 4.2 / 4.3 — Protocol cell labels not ER-verbatim: The Protocol panel labels at lines 444, 455 and 466 read “Trace dose”, “Sub-therapeutic prescription” and “Timing & frequency”, while the corresponding ER Therapeutic Protocol bold labels are “Trace-dose protocol:”, “Sub-therapeutic prescription protocol:” and “Time of day:”; the first two are abbreviated and the third is invented.
2. 10.4 — Value not from the ER Protocol section: [action_3_value] at line 469 includes “with food”, which does not appear in the ER Therapeutic Protocol section and is sourced instead from Risk Mitigation Strategies (ER line 422).

Fixes 08/08/2026 04:32

1. 4.2 / 4.3 — Protocol cell labels made ER-verbatim: [action_1_label] changed from “Trace dose” to “Trace-dose protocol”, [action_2_label] from “Sub-therapeutic prescription” to “Sub-therapeutic prescription protocol”, and [action_3_label] from the invented “Timing & frequency” to the ER’s “Time of day”.
2. 10.4 — Value restricted to the ER Protocol section: [action_3_value] changed from “Once daily, evening, with food” to “Evening, once daily”, removing “with food”, which came from Risk Mitigation Strategies rather than the ER Therapeutic Protocol section.