Audit: QRS - Nefiracetam for Health & Longevity

Audit conducted on 12/09/2026 06:59 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	93
Passed	85
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.	🟢	Spot-checked every populated span against the ER: protocol cells vs ER Therapeutic Protocol (lines 313, 319, 321, 323, 325), time cells vs ER lines 149, 155, 321, 368, gates vs ER lines 263–287, tiers vs ER Expected Benefits / Potential Risks & Side Effects, monitoring vs ER table lines 402–409. No unsupported statement found.
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.	🟢	The ER’s hedges survive where they are load-bearing: the at-a-glance keeps “one contested finding” and “a smaller repeat attempt found nothing”, and the animal-only toxicities sit in the Speculative tier, matching the ER.
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”).	🟢	All seven ER “Populations who should avoid Nefiracetam” entries are carried as Contraindications, not as cautions; no benefit is lifted above the ER’s tier.
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’s avoid-list, Key Interactions only from the ER’s interaction bullets, Benefits/Risks only from their respective tiered sections; no Benefit- or Risk-Modifying Factor appears in 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.	🟢	The QRS contains no PMIDs, no NCT identifier, no author or expert name and no brand name anywhere.
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.	🟢	Detached, evidence-first register throughout, mirroring the ER (“What survives is one contested finding”).
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Doses, thresholds and biomarker ranges are given precisely while the prose stays readable; the sheet gives the reader the means to judge rather than a verdict.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Cells describe what was studied (“The only regimen with controlled human data”) rather than instructing.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No prescriptive verbs directed at a reader; the only advisory text is the fixed template disclaimer.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	Impersonal constructions are used throughout (“Doses are placed…” becomes “Morning and early afternoon”; “placement avoids overlap with sleep onset”).
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronoun occurs anywhere in the document.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Plain equivalents are used where the ER offers them (“the brain’s main calming receptor” → “calming-receptor action”); remaining technical terms (renal papillary necrosis, estradiol) are the ER’s own biomarker and condition names.
2.8	Information is presented in a concise and very compact manner	🟢	Every gate and tier item is a short noun phrase; ER trailing rationale clauses are dropped.
2.9	It DOES NOT address the reader directly	🟢	Confirmed: no direct address in any span, including the at-a-glance lede.
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 sheet foregrounds the unresolved organ-toxicity signal and an eight-marker monitoring panel — content only a risk-aware, proactive user would act on.
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.	🟢	Baseline plus 6-week and 12-week laboratory panels, semen analysis and divided dosing with a fat-containing meal all assume that willingness.
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.	🟢	Nothing is simplified to a general-population takeaway; thresholds and functional ranges are retained.
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.	🟢	The at-a-glance states plainly that the only human signal came from depressed stroke patients and that the memory claim rests on animal work — the distinction that matters for a healthy optimizer.
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 title 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)”; “oral” / “administered orally” not “taken by mouth” / “given by mouth”; “injection” not “shot”; “adverse event” not “bad reaction”). This holds on EVERY surface, including the QRS lede — the stricter plain-language bar (see 2.7) does not license lay phrasing for route of administration. Direct quotes from sources are exempt.	🟢	No “pill”, “shot”, “taken by mouth” or similar; the lede uses “medicine”, “dose” and “doses”, matching the ER’s own register.

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 sixteen fixed strings match the template byte-for-byte (QRS lines 446, 491, 541, 568, 588, 622, 648, 652–654, 778 and the four tier labels in each tiered list).
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	64 uniquely named spans present; every template name (page_title, header_, at_a_glance, action_1–3_, time_1–3*, benefits, stop_items, caution_items, risks_, marker__name/target/why, monitoring_cadence, qualitative_item_) is accounted for, plus the three website= spans.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	A line-by-line comparison of the QRS against [qrs_template] shows the doctype comment, entire <style> block, header scaffolding, website= spans and footer are identical; only checklist-governed spans differ.

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 mapped onto the QRS is empty; the absent benefit and risk tiers are handled under 12.5 / 13.5, which mandate display:none rather than empty-state text.
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.	🟢	“Trial-grade regimen”, “Best time of day”, “Take with fat” and “Half-life and accumulation” are the ER’s own bold Protocol labels, reproduced verbatim; the monitoring row labels reproduce the ER biomarker column verbatim.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	No invented label; time-cell labels reuse the ER’s benefit headings and all eight marker names match the ER table exactly.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji anywhere; the ER’s 🟩/🟥/🟨 tier markers and the “⚠️ Conflicted” flags were correctly dropped in favor of the tier labels and CSS palette.
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.	🟢	Content sits within the template’s per-section budget: 3 protocol cells, 3 time cells, 2 benefit lines, 3 risk lines, 7 contraindications, 8 interactions, 8 marker rows, 6 qualitative items, each reduced to a short phrase.

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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 opens on line 2, immediately after the doctype, and precedes the template’s own comment on line 16.
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, closing “—” on line 13; the preceding caption text sits above the opener.
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.	🟢	It is inside an HTML comment; no metadata value is repeated in the header, body or footer.
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 nine 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]”	🟢	Line 4: er_filename: nefiracetam_2026-0912-0553_Opus_ER.md, matching the ER’s own filename field.
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: 26.9.11, 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: 2026-0912-0654, correct YYYY-MMDD-HHMM form.
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 with no context-window or other qualifier appended.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	Line 9: qrs_filename: nefiracetam_2026-0912-0553_Opus_QRS.html, identical to the file’s actual name.
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 the added git_user and git_issue values, which are unquoted and untrimmed of nothing.

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: Nefiracetam for Health & Longevity - Quick Reference Sheet, matching ER canonical_topic with the ampersand 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: Nefiracetam for Health & Longevity.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	Line 421: 09/12/2026, the correct MM/DD/YYYY rendering of 2026-0912.
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.	🟢	The header block (lines 415–428) is the template scaffold with only the two variables filled; 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	🟢	Lines 434–438 compress ER lines 440–442: failed development, the single contested motivation finding, the animal-only basis of the memory claim, and the dog organ toxicity.
7.2	[at_a_glance] is no longer than 60 words	🟢	58 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Each of the four statements traces to a distinct ER Conclusion sentence (lines 440 and 442).
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronym appears; “contested finding”, “repeat attempt” and “kidney and testicular damage” are ordinary usage.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	Trials are referred to only as “the decisive stroke study” and “a smaller repeat attempt”; no name, year or n.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No numeric effect measure, confidence interval or standardized mean difference is carried over from the ER.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All seven items map one-to-one onto the ER’s “Populations who should avoid Nefiracetam” list (ER lines 281–287).
8.2	[stop_items] represent the Contraindications from the ER	🟢	Complete and in ER order: conception, pregnancy/lactation, chronic kidney disease, liver impairment, seizure disorder, hypersensitivity, under 18.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Seven <li> elements inside the span (QRS lines 571–583).
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.	🟢	Every ER em-dash clause is stripped (“— the sponsor’s own trial excluded them…”, “— no human reproductive data of any kind”, “— the compound has never been studied in that age group”), as is the ER’s “which trial protocols excluded outright”.
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).	🟢	“within three months” is kept; all renal thresholds (25 mL/min, 30 mg/dL, 2.0 mg/dL) and hepatic thresholds (3× upper reference limit, bilirubin 2.0 mg/dL) are preserved, moved into parentheses.
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’s avoid-list uses no ranking notation inside parentheses.
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 seven such populations and the section is correctly populated, not empty.
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 eight items map one-to-one onto the ER’s interaction bullets (ER lines 263–277), in the same order.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	No overlap: the anticonvulsant class appears only in Contraindications, and none of the eight interaction entries duplicates an avoid-list population.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Eight <li> elements inside the span (QRS lines 591–612).
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 “Caution/Monitor;… Mitigation:…” tail is removed, as is the inline gloss “— a choline source” inside the alpha-GPC parenthesis.
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 eight named-drug parentheses are preserved in full, including the split inhibitor/inducer pairing for CYP1A2.
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’s interaction bullets use plain comma-separated drug lists, with no ranking notation.
9.7	The section is left empty ONLY IF the ER’s Key Interactions & Contraindications section identifies no interaction, additive effect, or exposure that changes how the intervention is used.	🟢	The ER names eight interactions and the section is correctly populated, not empty.
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 draw on the ER Therapeutic Protocol bullets at lines 313, 319, 323 and 325.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Dose/duration, timing and administration with food are the three decisions a user must make first; the remaining ER bullets are modifiers of these or are non-actionable comparisons.
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 Protocol section contains twelve actionable bullets, 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 spans carry ER-derived content; the labels are the ER’s own bold labels and each sub-line restates an ER Protocol sentence.

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 two graded human benefits (apathy, severe depression, both read out at 12 weeks) plus the onset/steady-state fact from ER lines 321 and 368.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Apathy precedes severe-depression mood — the ER’s own Low-tier order — with the benefit-independent steady-state cell placed last.
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 time-to-effect statements, 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 spans populated; values (“12 weeks”, “12 weeks”, “Steady state by day 7”) and subs trace to ER lines 149, 155, 321 and 368.
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 explicit 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	🟢	The two Low entries and five Speculative entries correspond exactly to the ER’s Low and Speculative headings (ER lines 145, 151, 159–177).
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present at QRS lines 543, 546, 549, 555.
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; the “⚠️ Conflicted” flags, Magnitude paragraphs and “Net:” sentences are all excluded.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parenthetical content survives; n = 70, n = 13, the confidence interval and the standardized mean difference of 0.51 are all absent.
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.	🟢	The ER records no High and no Medium benefit; both spans carry style="display: none" with the placeholder text removed (QRS lines 543–548).

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	One Medium, two Low and four Speculative entries correspond exactly to the ER headings at lines 207, 215, 221, 229, 233, 237 and 241.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present at QRS lines 624, 627, 630, 636.
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; the M-18 metabolite explanation, dog/rat dose levels and Magnitude paragraphs are excluded.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses remain; the ER’s “(death of the innermost kidney tissue)” gloss and the 75% mislabelling figure are both absent.
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.	🟢	The ER records no High risk; the span carries style="display: none" with the placeholder removed (QRS lines 624–626).

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	All rows come from the ER Monitoring Protocol & Defining Success biomarker table (ER lines 400–409).
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All eight ER table rows are present in order, with Target and Why columns reproduced verbatim (serum creatinine, eGFR, BUN, urine specific gravity/osmolality, ALT, total testosterone, estradiol, semen analysis).
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.	🟢	QRS lines 769–772 reproduce the ER’s schedule: baseline before the first dose, 6 weeks, 12 weeks, then every 3–6 months if use continues (ER lines 396, 398).

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	The six items come from the ER’s “Qualitative markers worth tracking alongside the laboratory panel” list (ER lines 413–418).
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All six are present in ER order: motivation/initiative, mood stability, cognitive clarity and word-finding, sleep onset latency and morning grogginess, headache frequency, nausea or abdominal discomfort.

Issues 12/09/2026 06:59

Pass rate 100.00%. No issues found.