Audit: QRS - Metformin for Health & Longevity

Audit conducted on 07/08/2026 22:42 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	91
Passed	81
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.	🟢	Spot-checked across all populated spans: protocol doses, time-to-effect windows, benefit and risk tier headings, all 13 biomarker targets and rationales, monitoring cadence, and qualitative markers all trace to explicit ER passages.
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.	🟢	action_1_sub preserves “No trial has compared low-dose against standard-dose for any aging endpoint: an inference from mechanism, not a validated regimen”; time_3_sub preserves the “putative”/”cannot be observed by the individual” 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”).	🟢	Contraindication thresholds, severity classes, and the “Speculative” tier assignments are carried at ER strength; no hedge 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.	🟢	Benefits come only from Expected Benefits, risks only from Potential Risks & Side Effects, gates only from Key Interactions & Contraindications, markers only from Monitoring Protocol & Defining Success. No modifying-factor content is surfaced as a gate or side effect.
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, NCT IDs, expert names, or brand names appear anywhere in the QRS; only generic drug and supplement names taken verbatim from the ER interaction bullets.
1.6	The QRS does not introduce new attributions.	🟢	The only attribution-shaped phrase, “used by leading practitioners”, is the ER’s own bold label in the Therapeutic Protocol section.

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, conflict-acknowledging register matches the ER throughout, including the unresolved framing of the aging claim.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Decision gates, quantified targets, and a self-tracking Qualitative Assessment give the reader actionable levers while staying objective.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Content is presented as reported practice and measured data, not as instructions issued to a patient.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperatives or “should” constructions; protocol and cadence entries are nominal descriptions of documented practice.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	Phrasings such as “Initiation with the evening meal, increasing by 500 mg weekly as tolerated” describe rather than instruct.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the document.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms are confined to decision gates and biomarker rows where they are load-bearing; the At-A-Glance and protocol subs use plain wording.
2.8	Information is presented in a concise and very compact manner	🟢	Gate items, benefit and risk tiers, and biomarker rationales are single condensed phrases with no ER prose carried over.
2.9	It DOES NOT address the reader directly	🟢	Confirmed: no “you”, “your”, or direct-address constructions.
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.	🟢	The longevity-oriented protocol is the first protocol cell, and the marker targets use optimal-functional rather than conventional-laboratory ranges.
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.	🟢	A 13-marker monitoring panel with a multi-interval cadence and daily symptom tracking presumes exactly this audience.
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.	🟢	Depth of the monitoring, interaction, and contraindication content is well beyond general-population material.
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.	🟢	Training-adaptation blunting is elevated to the Medium risk tier and echoed in the qualitative markers and dose-timing rationale, matching the ER’s audience-specific weighting.
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.	🟢	“Longevity-oriented protocol”, “biological aging”, “slowing of aging” are used; 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)”; “injection” not “shot”; “adverse event” not “bad reaction”). Direct quotes from sources are exempt.	🟢	“Oral medication”, “extended-release”, “hepatic glucose production”, “hypersensitivity”; the plainer wording in At-A-Glance (“digestive upset”, “blood sugar”) is taken verbatim from the ER Conclusion and is required by item 7.4.

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 present and unmodified (lines 446, 495, 544, 578, 600, 634, 663, 812) with tier labels and the Marker/Target/Why headers intact.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	79 named spans present and complete: header set, at_a_glance, action_1–3, time_1–3, benefits and risks tiers, stop_items, caution_items, marker_1–13 triplets, monitoring_cadence, qualitative_item_1–6.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	The non-variable website="evidence_review", website="audit", and website="full_review" spans, the stylesheet link, and the whole style block are 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 relevant to the QRS is empty; every benefit tier, risk tier, gate, and monitoring row has ER content.
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.	🟢	action_1/2/3_label reproduce “Longevity-oriented protocol”, “Standard glycemic protocol used by leading practitioners”, “Best time of day”; all six qualitative item labels reproduce the ER bold labels verbatim.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	All 13 marker_#_name values match the ER biomarker table entries character for character.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji in the document; the ER’s tier and “⚠️ Conflicted” markers were correctly dropped in favour of CSS palettes and bold tier labels.
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 the per-section budget — gate items and benefit/risk tiers are bare phrases, biomarker rationales are single clauses, and the cadence paragraph is compressed from the ER’s two prose paragraphs; no ER passage is carried at full length.

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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.	🟢	Lines 2–14: the metadata comment immediately follows <!doctype html> on line 1 and precedes every other comment and the <html> element.
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 --- on line 3 and closing --- on line 13, with the descriptive lead-in text on line 2.
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; none of its values are repeated in the header, footer, or any card.
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: "00:04" is quoted, correctly so because it contains a colon; all other values are bare and trimmed.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	Line 4: er_filename: metformin_2026-0807-1922_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 version badge at the top of 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)	🟢	Line 6: qrs_creation_date: 2026-0807-2210, correctly formatted.
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” is nickname plus version number with no additional qualifier.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	Line 9: qrs_filename: metformin_2026-0807-1922_Opus_QRS.html, matching the actual filename.
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 ten keys; only the colon-bearing duration value is quoted.

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: “Metformin for Health & Longevity - Quick Reference Sheet”, matching canonical_topic with the ampersand entity-encoded.
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: “Metformin for Health & Longevity”.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	Line 421: 08/07/2026, the correct MM/DD/YYYY rendering of 2026-0807-2210.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	Line 425: “Opus 5”, matching the frontmatter value.
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 the title and the template subline; the ER’s “Also known as” list, prompt version, and audit data are absent.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Compresses the four load-bearing moves of the ER Conclusion: established glycemic evidence, the unresolved aging claim, the corrected-versus-primate split, and the documented costs.
7.2	[at_a_glance] is no longer than 60 words	🟢	56 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Each clause maps to a distinct sentence of the ER Conclusion; no synthesis beyond it.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	Uses “blood sugar”, “response to insulin”, “monkey data”, “digestive upset”; the only abbreviation, “vitamin B12”, is everyday nutritional vocabulary and is the ER’s own wording.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial name, year, cohort, or sample size appears.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No numeric effect estimate, hazard ratio, or confidence interval appears.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All ten stop_items trace to the ER “Populations who should avoid this intervention” bullet and the Alcohol bullet in that section.
8.2	[stop_items] represent the Contraindications from the ER	🟢	The five absolute contraindications, the eGFR 30–45 initiation restriction, the untreated-B12 and over-80 exclusions, the sustained-heavy-alcohol contraindication, and the temporary-withholding situations are all present.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Lines 581–595: ten discrete <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.	🟢	No item carries mechanism, mitigating action, or a trailing dash clause; the only en dash is inside the numeric range “30–45”.
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).	🟢	“(New York Heart Association Class IV)”, “(Child-Pugh Class C)”, “eGFR below 30 mL/min/1.73 m²”, “eGFR 30–45”, “eGFR is below 60”, and “until repletion” are all retained.
8.6	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	The ER Key Interactions & Contraindications section uses no ranking notation inside parentheses.
8.7	If no [stop_items] are present the section is left empty	N/A	Ten stop_items are present.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	Each caution_item maps to one of the ER interaction bullets in that section.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	All ten ER interaction bullets are represented (the “Other interventions” bullet correctly split into two items); the “Populations who should avoid this intervention” bullet is not repeated here.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Lines 603–624: eleven discrete <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.	🟢	Every item is a class name plus an example list; the ER’s “Severity —” and “Mitigating action:” clauses are stripped throughout.
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).	🟢	Contrast agents, carbonic anhydrase inhibitors, cation-transport inhibitors, renal-perfusion drug classes, secretagogue classes, OTC agents, and the seven glucose-lowering supplements are all retained in parentheses.
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 interaction bullets use no ranking notation inside parentheses.
9.7	If no [caution_items] are present the section is left empty	N/A	Eleven caution_items 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	🟢	Longevity-oriented dosing, the standard glycemic titration schedule, and time-of-day are the three implementation decisions the ER treats as actionable for this audience.
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 Therapeutic Protocol section supplies ten bullets, well over three distinct actionable aspects.
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section.	🟢	All nine spans carry ER-derived content, including the maximum licensed doses and the “inference from mechanism, not a validated regimen” 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	🟢	Glucose lowering, full HbA1c response, and weight effects are the three quantified windows in the ER “Time to effect” bullet; the unobservable aging horizon is folded into time_3_sub.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Ordered glycemic effect first, then its confirmatory HbA1c window, then the smaller weight effect, matching the ER’s own ordering within the High benefit tier.
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	The ER supplies more than three distinct time-to-effect aspects.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢	All nine spans carry ER-derived content (“Days to 1–2 weeks”, “~3 months”, “3–6 months” with matching rationales).
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 Practical Considerations section provides an explicit “Time to effect” bullet.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	All twelve listed benefits correspond one-to-one with the ER Expected Benefits sub-headings.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present and populated at lines 546, 553, 560, 566, in the ER’s tier order.
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 bare ER heading; no **Magnitude:** figure or mechanistic sentence is carried across.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any benefits span.
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 in the ER, so no span needs hiding.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	All eleven listed risks correspond one-to-one with the ER Potential Risks & Side Effects sub-headings.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present and populated at lines 636, 639, 645, 652, in the ER’s tier order.
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 bare ER heading; incidence figures, case-fatality rates, and mechanism sentences are all 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 risks span.
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 in the ER, so no span needs hiding.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	The table and cadence both derive from the ER Monitoring Protocol & Defining Success section.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All 13 rows of the ER biomarker table are present in ER order, with targets and rationales reproduced 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.	🟢	Lines 800–806 reproduce the ER’s full ongoing-monitoring schedule: renal and metabolic panel intervals, the eGFR 45 escalation, HbA1c/insulin/HOMA-IR, B12 with the 400 pg/mL methylmalonic acid trigger, annual complete blood count, and fitness and body composition intervals.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	All six items derive from the qualitative-marker bullets at the end of the ER Monitoring Protocol & Defining Success section.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All six ER qualitative markers are present with their bold labels verbatim: digestive tolerance, training performance and recovery, strength and lean mass trajectory, neurological symptoms, energy/cognitive clarity/mood, and sleep quality.

Issues 07/08/2026 22:42

Pass rate 100.00%. No issues found.

Issues 07/08/2026 22:31

1. 2.4 / 2.5 — Imperative “Withhold:” in Contraindications: The final Contraindications item (line 595) opens with the imperative “Withhold:”, turning the ER’s descriptive “Metformin should be withheld during acute illness…” (ER line 375) into a clinical instruction rather than presented information.
2. 4.5 — Content exceeds one-page budget: The protocol and time-to-effect sub-texts (lines 456–460, 473–477, 488–492, 535–538), the ~75-word cadence paragraph (lines 802–809), and the full-sentence qualitative items (lines 818–853) were carried over at ER length rather than condensed, pushing the sheet well past one A4 page.

Fixes 07/08/2026 22:31

1. 2.4 / 2.5 — Imperative “Withhold:” removed: The final Contraindications item now reads “Temporary withholding: acute illness with dehydration, sepsis, hypoxia, or shock; major surgery; iodinated contrast when eGFR is below 60”, replacing the directive verb with a descriptive label.
2. 4.5 — Protocol and time-to-effect subs condensed: All three action_#_sub spans and time_1_sub / time_3_sub were tightened (e.g., “Maximum licensed doses are 2,550 mg daily for immediate-release and 2,000 mg daily for extended-release” → “Maximum licensed: 2,550 mg daily immediate-release, 2,000 mg daily extended-release”).
3. 4.5 — Monitoring cadence shortened: monitoring_cadence was compressed from ~76 to ~68 words by merging the 3- and 6-month kidney checkpoints and dropping redundant connectives, with every cadence interval and threshold preserved.
4. 4.5 — Qualitative items trimmed: Items 1–3 were shortened to their core observables (e.g., “tracked daily during titration and after any dose change” → “tracked daily during titration”), keeping the ER’s bold labels verbatim.

Issues 07/08/2026 22:24

1. 8.2 — Missing relative eGFR contraindication: The ER contraindication bullet (line 375) states “Initiation is not recommended at eGFR 30–45”, but [stop_items] lists only “eGFR below 30 mL/min/1.73 m²”, dropping the 30–45 threshold that governs whether initiation is appropriate.

Fixes 07/08/2026 22:24

1. 8.2 — Missing relative eGFR contraindication: Added the stop item “Initiation not recommended at eGFR 30–45 mL/min/1.73 m²” to [stop_items], directly after the absolute “eGFR below 30 mL/min/1.73 m²” entry, restoring the 30–45 threshold stated in ER line 375.

Issues 07/08/2026 22:14

1. 10.1 — Protocol cell sourced from wrong ER section: The action_2 label “Low starting dose with slow titration” and value “+500 mg every 1–2 weeks” are taken verbatim from the ER Risk Mitigation Strategies bullet at line 380 rather than from the Therapeutic Protocol section, whose corresponding bullet (line 403) is “Standard glycemic protocol used by leading practitioners” with “increasing by 500 mg weekly”.

Fixes 07/08/2026 22:14

1. 10.1 — Protocol cell sourced from wrong ER section: Rebuilt the action_2 cell from the ER Therapeutic Protocol bullet instead of Risk Mitigation Strategies — label changed from “Low starting dose with slow titration” to “Standard glycemic protocol used by leading practitioners”, value from “500 mg daily, +500 mg every 1–2 weeks” to “500 mg daily, titrated to 1,000 mg twice daily”, and the sub replaced with the Protocol section’s weekly titration and maximum licensed dose figures.