Audit: QRS - MDMA for Health & Longevity

Audit conducted on 12/09/2026 07:45 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

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. 🟢 Spot-checked every populated span against the ER: protocol dose/regimen/time of day (ER 395-405), time-to-effect (ER 452, 169), benefit and risk tier headings (ER 149-325), all 10 monitoring targets and “Why” strings (ER 484-493) and the cadence (ER 478-480) are all literally present in the ER.
1.2 Where the ER uses cautious phrasing (“not formally studied”, “None documented in human trials to date”, “theoretical concern”, “data are limited”), the QRS uses the same phrasing. 🟢 ER hedges are carried where the QRS reproduces them, e.g. marker_10_target “No established target; normal metaboliser status is the reference” (ER 493).
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; “Pregnancy and breastfeeding” stays an absolute contraindication, MAOI two-week window preserved.
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. 🟢 All stop_items come from the ER “Populations who should avoid MDMA” list plus the two bullets the ER marks “Absolute contraindication”; all caution_items come from the ER interaction bullets. No Benefit- or Risk-Modifying Factor is surfaced as a gate.
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 citations, expert 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 in the QRS.

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. 🟢 Matches the ER’s measured, explicitly conflicted register.
2.2 The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging 🟢 Expert and data-driven (numeric targets, tiered evidence) while remaining readable.
2.3 The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor 🟢 Descriptive noun phrases throughout; no directives issued to a reader.
2.4 The QRS avoids language that implies medical or clinical advice 🟢 Content is framed as what supervised protocols did and measured, not as instruction; footer disclaimer retained unchanged.
2.5 The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” 🟢 No “should”, “must”, “recommended” or “advised” anywhere in the document body.
2.6 The QRS never addresses “the reader” directly — it presents evidence, not guidance 🟢 No second-person pronouns present.
2.7 The QRS is written in plain language, avoiding unnecessary medical jargon 🟢 Clinical terms used are the ER’s own and are load-bearing (hyponatraemia, Child-Pugh, eGFR); no gratuitous jargon added.
2.8 Information is presented in a concise and very compact manner 🟢 Every span is a stripped noun phrase; magnitudes, rationale and citations removed relative to the ER.
2.9 It DOES NOT address the reader directly 🟢 Confirmed: no direct 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. 🟢 Framing assumes a reader who would screen, dose and monitor deliberately.
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. 🟢 Presents a 40-therapist-hour, multi-session, laboratory-monitored regimen without discounting it as impractical.
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. 🟢 Baseline panel, hourly vital signs and 12-month follow-up exceed a general-population framing.
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. 🟢 Risk tiering keeps the setting/supply distinction the ER makes, which is exactly where the signal differs for a controlled-setting reader.
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 string “anti-aging” does not occur.
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. 🟢 Uses “oral dose”, “beats per minute”, “Morning dosing”; no “pill”, “shot”, or “taken by mouth”.

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 verified verbatim: “Protocol”, “Time to effect”, “Benefits”, “Risk & Side Effects”, “Monitoring”, “Qualitative Assessment”, “Contraindications”, “Key Interactions”, “High/Medium/Low/Speculative”, “Marker/Target/Why”.
3.2 All “<span data-qrs-var=”NAME”>…</span>” from the [qrs_template] are present in the the QRS. 🟢 All 38 template span names present; the repeated marker_#* and qualitative_item# patterns are expanded to 10 and 7 numbered instances respectively.
3.3 Spans that are not addressed in a checklist item are left unchanged 🟢 Structural diff against the template shows the head, CSS block, website=”evidence_review” / website=”audit” / website=”full_review” spans and footer are byte-identical.

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 drawn on by the QRS is empty, so no empty-state phrasing applies.
4.2 Where the ER presents a bulleted item as “Label: content”, the QRS uses the ER’s bold label verbatim as the cell or row label. 🟢 Protocol cell labels “Dose”, “Standard supervised regimen” and “Time of day” reproduce the ER bold labels at ER 395-405 verbatim.
4.3 Labels are not paraphrased, abbreviated, or invented. 🟢 Monitoring row labels reproduce the ER biomarker table’s first column; time-to-effect labels mirror the ER benefit headings.
4.4 The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. 🟢 No emoji characters in the file; the ER’s tier emoji and “⚠️ Conflicted” markers are 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. 🟢 Each section is a condensed form of its ER source with magnitudes, mechanisms and citations stripped; nothing is padded and no section is extended beyond the template’s per-section slots.

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 on line 2, immediately after the doctype 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. 🟢 YAML opens at line 3 and closes at line 13; the preamble text on line 2 sits before the opening delimiter.
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. 🟢 Inside an HTML comment and not duplicated anywhere 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. 🟢 All values trimmed; only duration: “00:03” is quoted, which is required because it contains a colon.
5.5 The filename of the source ER is stated as “er_filename: [er_filename]” 🟢 er_filename: mdma_2026-0912-0425_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]” 🟢 qrs_prompt_version: 26.9.11, 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) 🟢 qrs_creation_date: 2026-0912-0737
5.8 The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]” 🟢 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) 🟢 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]” 🟢 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) 🟢 Nickname plus version number only; no “(1M context)” or other qualifier.
5.12 The filename of the document is stated as “qrs_filename: [filename of this document]” 🟢 qrs_filename: mdma_2026-0912-0425_Opus_QRS.html, matching the file 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: 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., &amp; for &) 🟢 <title>MDMA for Health &amp; Longevity - Quick Reference Sheet</title>
6.2 [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., &amp; for &) 🟢 header_topic: MDMA for Health &amp; Longevity
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢 2026-0912-0737 renders as 09/12/2026.
6.4 [header_subline_model] is set to [qrs_creator_ai_fullname] 🟢 header_subline_model: 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 byte-identical to the template apart from the two variable spans; the ER’s “Also known as” line is 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 🟢 Condenses the three paragraphs of the ER Conclusion (ER 527-531) into the same order: acute effect, benefit hierarchy, harm attribution, unresolved verdict.
7.2 [at_a_glance] is no longer than 60 words 🟢 59 words, counted mechanically.
7.3 Every fact in [at_a_glance] is supported by a distinct passage in the ER. 🟢 Each clause maps to a distinct Conclusion passage: ER 527 (floods the brain), ER 529 (benefit hierarchy, harm attribution), ER 531 (unresolved).
7.4 It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead 🟢 No acronyms or classifications; “serotonin”, “oxytocin”, “trauma symptoms”, “heavy drinking” are plain-language.
7.5 It DOES NOT cite specific trials (names, years, sample sizes, p-values) 🟢 No trial names, years, sample sizes or p-values.
7.6 It DOES NOT cite effect sizes, relative risks, or statistical results 🟢 No effect sizes, relative risks or statistics.

8. Contraindications

# Description Result Comments
8.1 The section is derived from the ER Key Interactions & Contraindications section 🟢 Drawn from ER 341-371.
8.2 [stop_items] represent the Contraindications from the ER 🟢 All nine entries of the ER “Populations who should avoid MDMA” list are represented, plus the two bullets the ER labels “Absolute contraindication” (MAOIs, ritonavir-boosted regimens); the MAOI drug list and the two-week window are merged into one item.
8.3 Individual [stop_items] are formatted as <li></li> 🟢 Ten <li> elements inside the stop_items 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. 🟢 All ER rationale stripped, e.g. “Uncontrolled diabetes” without the ER’s “given reported ketoacidosis after acute toxicity” tail (ER 371); no em-dash 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). 🟢 Thresholds and classes all preserved: 450/470 ms QT, 140/90 mmHg, NYHA III-IV, Child-Pugh B/C, 3x transaminase limit, eGFR below 60, 6-month infarction window, 2-week MAOI window.
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 section is populated, and the ER does identify populations who should avoid MDMA, so the empty-only condition is not triggered.
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 The section is not empty.

9. Key Interactions

# Description Result Comments
9.1 The section is derived from the ER Key Interactions & Contraindications section 🟢 Drawn from ER 341-359.
9.2 [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications 🟢 Seven items carry the ER’s seven “Caution” / “Caution to avoid” bullets; the MAOI and ritonavir bullets are correctly excluded because they appear under Contraindications.
9.3 Individual [caution_items] are formatted as <li></li> 🟢 Seven <li> elements inside the caution_items 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. 🟢 All mechanism and mitigation text stripped, e.g. the SRI item drops “Trial protocols required tapering and washout — at least five half-lives, six weeks for fluoxetine” (ER 345).
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). 🟢 Every ER example drug list preserved intact: SRIs, CYP2D6 inhibitors, the serotonergic supplement list including the 5-HTP expansion, and the thermogenic 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. 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 section is populated and the ER does name interactions, so the empty-only condition is not triggered.
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 The section is not empty.

10. Protocol

# Description Result Comments
10.1 The section is derived from the ER Protocol section 🟢 Drawn from the ER Therapeutic Protocol section (ER 393-419).
10.2 The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section 🟢 Dose, standard supervised regimen and time of day are the three actionable levers in the ER bullet list; the remaining bullets are background pharmacology or non-adjustable considerations.
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 names well more than three actionable implementation aspects, so 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 action spans populated from ER 395-405, including the 80-180 mg session total and the “Weight-adjusted dosing was not used” caveat.

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 🟢 Post-traumatic stress symptoms and social closeness come from the ER “Time to effect” bullet (ER 452); sleep quality comes from the sleep benefit magnitude (ER 169).
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢 Ordered High, High, Medium: the two ER High-tier benefits first, then the Medium-tier sleep benefit.
11.3 If less that three distinct time-to-effect aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing. N/A Three distinct time-to-effect aspects are present in the ER, so 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 time spans populated with ER-derived content.
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 does provide time-to-effect information (ER 452), so the section is correctly retained.

12. Benefits

# Description Result Comments
12.1 The section is derived from the ER Expected Benefits section 🟢 Drawn from ER 145-211.
12.2 Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] 🟢 All four tier spans present and populated.
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 sub-heading alone; no Cohen’s d, sample size, confidence interval or sponsorship caveat carried over.
12.4 Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 The ER benefit headings carry no parentheses, and none were introduced.
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 tiers have items in the ER, so no span needed hiding.

13. Risks

# Description Result Comments
13.1 The section is derived from the ER Potential Risks & Side Effects section 🟢 Drawn from ER 233-325.
13.2 Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] 🟢 All four tier spans present and populated.
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 sub-heading alone; odds ratios, incidence figures and the “Conflicted” markers are all dropped.
13.4 Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 The ER risk headings carry no parentheses, and none were introduced.
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. N/A All four tiers have items in the ER, so no span needed hiding.

14. Monitoring

# Description Result Comments
14.1 The section is derived from the ER Monitoring section 🟢 Drawn from the ER Monitoring Protocol & Defining Success section (ER 476-493).
14.2 All measurable/quantifiable biomarkers from the Monitoring section are listed 🟢 All ten rows of the ER biomarker table are present in the same order: serum sodium, home blood pressure, resting heart rate, core body temperature, ALT and AST, eGFR, corrected QT interval, PCL-5, PSQI, CYP2D6 genotype.
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. 🟢 Populated with the ER’s session-anchored cadence from ER 478-480: baseline panel, hourly vital signs for six hours, one-week labs, one- and two-month scores, full panel plus electrocardiogram at 6 and 12 months.

15. Qualitative Assessment

# Description Result Comments
15.1 The section is derived from the ER Monitoring section 🟢 Drawn from the ER qualitative marker list (ER 495-503).
15.2 All subjective/qualitative biomarkers from the Monitoring section are listed 🟢 All seven ER qualitative markers reproduced verbatim.

Issues 12/09/2026 07:45

Pass rate 100.00%. No issues found.