Audit: QRS - Low-Dose Aspirin for Health & Longevity

Audit conducted on 27/08/2026 17:40 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	93
Passed	83
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.	🟢	Protocol cells trace to ER lines 391/393/395; time-to-effect to ER line 448; benefits/risks to ER headings; gates to ER lines 329–361; monitoring rows to the ER table at lines 482–492.
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.	🟢	“possible reduction in risk of cancers outside the colon” retains the ER’s hedge; “no outcome trial has tested it” carried verbatim into action_3_sub.
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”).	🟢	Severity words (“Caution”, “Caution to absolute contraindication”, “Monitor only”) match the ER bullets exactly.
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 only from the ER “Populations who should avoid” list; Key Interactions only from the ER interaction bullets; no Benefit-/Risk-Modifying Factors migrated.
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.	🟢	The QRS contains no PMIDs, citations, expert names, NCT identifiers, or brand names.
1.6	The QRS does not introduce new attributions.	🟢	No attributions of any kind 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.	🟢	The measured, non-promotional register of the ER Conclusion is preserved throughout.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Decision-relevant thresholds and targets are given without hedging or alarm.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Content is stated as evidence, not instruction.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperatives directed at a reader anywhere in the sheet.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	Wording such as “Preferred over enteric-coated tablets” is carried from the ER as description, not recommendation.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns occur in the file.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms appearing (PI3K-altered, thrombocytopenia) are ER headings/terms with no plainer equivalent.
2.8	Information is presented in a concise and very compact manner	🟢	Every gate, benefit, risk and monitoring cell is a terse phrase; no ER prose is carried over.
2.9	It DOES NOT address the reader directly	🟢	Confirmed by full-text scan for second-person address.
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.	🟢	Baseline risk stratification (coronary calcium, lipoprotein(a), hs-CRP) is surfaced as decision input.
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.	🟢	An 11-marker monitoring panel and a multi-interval cadence are presented without simplification.
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 access to coronary calcium scoring, Lp(a) and H. pylori testing.
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 states the benefit is smaller “in those without” narrowed arteries — the stratification that matters 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.	🟢	The term “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.	🟢	“tablet”, “haemorrhage”, “thrombocytopenia”, “faecal immunochemical test” used; the plainer register in At-A-Glance is required by 7.4 and mirrors the ER Conclusion.

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 match the template byte-for-byte (lines 444, 485, 529, 553, 573, 604, 628, 632–634, 782).
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 38 distinct template variable names are present; marker_#* is expanded to 11 rows and qualitative_item# to 6 items as designed.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	The three website="..." spans (evidence_review, audit, full_review) and the footer disclaimer are byte-identical to 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”	N/A	No ER section drawn on by 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.	🟢	Protocol labels (“Standard dose”, “Formulation”, “Time of day”) and all 11 Key Interaction bold labels are verbatim ER labels.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Monitoring marker names match the ER table column 1 exactly, including “Estimated glomerular filtration rate” and “High-sensitivity C-reactive protein”.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji characters occur in the file; 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 section is condensed to minimal phrasing — no ER prose, citations, magnitudes, mechanisms or mitigations carried over — and no section was extended with additional structure.

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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 <!doctype html> on line 1.
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.
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 element on the sheet repeats any metadata value except those mandated by 6.3/6.4.
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.	🟢	Verified: no trailing whitespace on lines 3–13; only duration: "00:03" is quoted, and it contains a colon.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	Line 4: er_filename: low_dose_aspirin_2026-0827-1402_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 guideline version.
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: 2026-0827-1722.
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” is a single word with no version or qualifier.
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’s own name on disk.
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 including git_user and git_issue.

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 &)	🟢	Line 22: “Low-Dose Aspirin 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 &)	🟢	Line 417 matches ER canonical_topic with & encoded.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	Line 421: 08/27/2026, correct for 2026-0827-1722.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	Line 425: 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 contains only title and the template subline; 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	🟢	Mirrors ER lines 523/525: mechanism, secondary vs primary prevention, VTE, colorectal latency, then the harms.
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 maps to a distinct clause of the ER Conclusion at lines 523 and 525.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	“clot-forming blood cells” for platelets, “narrowed arteries” for atherosclerosis, “gut and brain bleeding”, “bowel cancer”; no acronyms.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial names, years or sample sizes appear.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No hazard ratios, confidence intervals or percentages; “after at least five years” and “after seventy” are latency/age qualifiers, not effect sizes.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All nine items come from the ER “Populations who should avoid Low-Dose Aspirin” list at lines 353–361.
8.2	[stop_items] represent the Contraindications from the ER	🟢	9 of 9 ER contraindications present, none added.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Nine <li> elements inside the stop_items span (lines 556–568).
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.	🟢	The Reye syndrome rationale, the “most advanced grade of liver failure” gloss and “until pressure is controlled” were all correctly 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).	🟢	Preserved: “within 12 months”, “Child-Pugh Class C”, “under 30 mL/min/1.73 m²”, “under 50 × 10⁹/L”, “325 mg or above”, “from 20 weeks’ gestation”, “above 160/100 mmHg”, “under 16”.
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 inside parentheses in this section.
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.	🟢	The ER names nine such populations and the section is populated accordingly.
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	The section is not empty.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All eleven items come from the ER bullets at lines 329–349.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	11 of 11 ER interaction bullets present; no overlap with the nine contraindications.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Eleven <li> elements inside the caution_items span (lines 576–594).
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.	🟢	Every ER “Mitigation:” clause and every quantified bleeding multiplier was stripped; only the severity word and its governing threshold remain.
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 seven ER example-drug lists preserved, plus “above 15 mg weekly”, “three or more drinks daily” and “vitamin E above 400 IU”.
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 inside parentheses in this section.
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.	🟢	The ER names eleven such interactions and the section is populated accordingly.
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	The section is not empty.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	All three cells trace to the ER Therapeutic Protocol bullets at lines 391, 393 and 395.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Dose, formulation and timing — the three executable decisions; half-life and the competing-allocation bullets are not actionable implementation steps.
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 three or more actionable aspects and 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.	🟢	All nine cells populated; no placeholders remain anywhere in the file.

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	🟢	The ER’s “Time to effect” bullet (line 448) names exactly three horizons; all three are represented.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Cardiovascular (largest benefit) → cancer → platelet inhibition (pharmacodynamic precondition).
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 exist and 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.	🟢	All nine cells populated; the 162–325 mg chewable loading-dose qualifier is carried from ER line 448.
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, so the section is correctly retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	All nine entries correspond to the nine #### headings under ER Expected Benefits.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present and populated (lines 531–546).
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.	🟢	Only ER heading text is carried; every “Magnitude:” line and citation was dropped.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses occur in any benefits entry.
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 ER tiers contain entries, so no span needed hiding.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	All ten entries correspond to the ten #### headings under ER Potential Risks & Side Effects.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present and populated (lines 606–622).
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.	🟢	Only ER heading text is carried; hazard ratios, confidence intervals and event rates were all dropped.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses occur in any risks entry.
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 ER tiers contain entries, so no span needed hiding.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Rows map one-to-one onto the ER Monitoring Protocol & Defining Success table at lines 482–492.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	11 of 11 ER biomarkers present, in ER order, with targets carried verbatim.
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.	🟢	Line 774 reproduces ER line 478 plus the annual FIT interval given in the ER table’s Context column.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	All six items come from the ER qualitative-marker list at lines 496–501.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	6 of 6 present, in ER order, none added.

Issues 27/08/2026 17:40

Pass rate 100.00%. No issues found.

Issues 27/08/2026 17:34

1. 4.5 — QRS exceeds one A4 page: The sheet carries 9 contraindications, 11 interactions, 11 monitoring markers and 6 qualitative items at near-full ER wording; the gate block (lines 552–600) and the Monitoring card (lines 629–782) each occupy roughly half an A4 page alone, putting the estimated total at about twice the one-page budget.

Fixes 27/08/2026 17:34

1. 4.5 — Contraindication items condensed: Trimmed the five wordiest stop_items while keeping every threshold and time window — e.g. “Active peptic ulceration or gastrointestinal bleeding within the preceding 12 months” to “Active peptic ulcer or gastrointestinal bleed within 12 months”, and “Uncontrolled hypertension above 160/100 mmHg until pressure is controlled” to “Uncontrolled hypertension above 160/100 mmHg”.
2. 4.5 — Interaction item condensed: Shortened the “Other interventions” caution_items entry from “Caution around any planned surgery, dental extraction, spinal injection, colonoscopy with polypectomy or cosmetic procedure” to “Caution around planned surgery, dental extraction, spinal injection, polypectomy or cosmetic procedure”.
3. 4.5 — Monitoring “Why” cells condensed: Tightened marker_3_why, marker_4_why, marker_5_why, marker_6_why, marker_7_why and marker_8_why to their key fact, removing roughly six wrapped table lines (e.g. “Uncontrolled hypertension is the main modifiable driver of brain bleeding on aspirin” to “Main modifiable driver of brain bleeding on aspirin”).
4. 4.5 — Coronary calcium target shortened: Reduced marker_10_target from “0 under age 60; above 60 no established target exists, so track the change from the individual’s own prior scan” to “0 under age 60; above 60 track change from prior scan”, cutting the tallest row in the Monitoring table.
5. 4.5 — Monitoring cadence compressed: Merged the repeated intervals in monitoring_cadence into “Full blood count and ferritin at 3 and 12 months, then every 1–2 years; blood pressure every 6 months; kidney function and faecal immunochemical test annually.”
6. 4.5 — Qualitative and benefits lines trimmed: Shortened qualitative_item_4 to “…falling haemoglobin shows up first as breathlessness” and benefits_high to “prevention of preeclampsia in at-risk pregnancy”, saving a wrapped line in each card.

Issues 27/08/2026 17:27

1. 1.3 — Methotrexate caution narrowed: The QRS interaction item at line 587 reads “Methotrexate: Caution, above 15 mg weekly”, which confines the caution to doses above 15 mg weekly; ER line 339 flags methotrexate as a caution in general and applies the 15 mg weekly threshold only to avoiding the combination.

Fixes 27/08/2026 17:27

1. 1.3 — Methotrexate caution narrowed: Changed the interaction item from “Caution, above 15 mg weekly” to “Caution; combination avoided above 15 mg weekly”, so the caution applies to methotrexate generally while the 15 mg weekly threshold governs avoidance, as in the ER.