Audit: QRS - PCSK9 Inhibitors for Health & Longevity

Audit conducted on 12/09/2026 23:13 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.	🟢	All protocol doses (140 mg q2w, 75 mg q2w, 284 mg q6m), time values (1-2 weeks, ~1 year, 18 months), all 10 biomarker targets, all tier items and both gate lists trace to literal 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.	🟢	The ER’s “⚠️ Conflicted” markers are carried as “(conflicted)” on mortality, diabetes, neurocognitive, muscle and bone items.
1.3	The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”).	🟢	Contraindications remain contraindications; no hedging added or removed.
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.	🟢	Gate items come only from Key Interactions & Contraindications; tier items only from Expected Benefits / Potential Risks & Side Effects.
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.
1.6	The QRS does not introduce new attributions.	🟢	No attributions present.

2. Focus, Tone & Audience

#	Description	Result	Comments
2.1	The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing.	🟢	Measured, non-promotional register matches the ER throughout.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Quantified targets and tiered evidence presented without hype or alarm.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Doses and targets are stated as evidence, not issued as orders.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperatives or prescriptive constructions.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No “recommend”, “advise” or “should” constructions in the QRS voice.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the file.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms appear only where the ER itself requires them; the lede is jargon-free.
2.8	Information is presented in a concise and very compact manner	🟢	Every tier item, gate item and marker row is a compressed fragment.
2.9	It DOES NOT address the reader directly	🟢	Confirmed: no “you”/”your” tokens.
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.	🟢	Optimal functional ranges rather than conventional laboratory flags are used throughout Monitoring.
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.	🟢	Fortnightly injection schedules and a 10-marker panel are presented without dilution.
2.12	The document is NOT written for the general population, who are unwilling to employ lifestyle and behavioral changes or follow protocols that may be inconvenient, costly, or require effort.	🟢	Content assumes willingness to test, inject and track.
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 lede states plainly that benefit is small where risk is low, matching the ER’s risk-stratified reading.
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; the title carries “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.	🟢	Route of administration is given as “Subcutaneous injection” / “Subcutaneous”; the lede uses “medicines” and “injection-site irritation”, with no “pill” or “shot”.

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, gate headings, tier labels and column headers are byte-identical to the template.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	Span-name comparison against the template shows full parity; the marker_#_* and qualitative_item_# families are expanded to markers 1-10 and items 1-4.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	A line-by-line comparison against the template shows changes confined to variable content; the website="evidence_review", website="audit" and website="full_review" spans, the CSS block and the footer 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 drawn on by the QRS is empty; all four benefit and risk tiers, both gate lists and the monitoring table are populated.
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 “Evolocumab dosing”, “Alirocumab dosing”, “Inclisiran dosing” match the ER bold labels verbatim; monitoring row labels match the ER table’s biomarker names verbatim.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Every ER-supplied label is carried verbatim; the time-to-effect cell labels derive from a single ER prose bullet that supplies no per-item labels.
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; tiering is carried by the bold “High:”/”Medium:”/”Low:”/”Speculative:” labels and CSS.
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.	🟢	Six items per gate, one line per benefit and risk tier, ten compact marker rows and four qualitative items sit inside the one-page budget.

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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.	🟢	The comment opens at line 2, immediately after <!doctype html>, and closes at line 14 before any other content.
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 and closing --- at line 13; the preceding descriptive text sits outside the block.
5.3	The metadata is not visible in any rendered view of the QRS and is not surfaced by any other element on the sheet.	🟢	Contained wholly in an HTML comment; no metadata value is echoed into the body.
5.4	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	Only duration: "00:03" is quoted, and it contains a colon that requires it.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	er_filename: pcsk9_inhibitors_2026-0912-2026_Opus_ER.md, matching the ER frontmatter filename.
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: 2026-0912-2307, in the required format.
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 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]”	🟢	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 trailing qualifier.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	qrs_filename: pcsk9_inhibitors_2026-0912-2026_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-checked across all nine keys; no stray whitespace and no unnecessary quoting.

6. Page Title & Header

#	Description	Result	Comments
6.1	[page_title] is set to the [canonical_topic] of the ER frontmatter followed by “ - Quick Reference Sheet” (e.g., “Intervention - Quick Reference Sheet”). The [canonical_topic] is HTML-entity-encoded as needed (e.g., & for &)	🟢	“PCSK9 Inhibitors for Health & Longevity - Quick Reference Sheet”, 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 &)	🟢	“PCSK9 Inhibitors for Health & Longevity”, matching the ER canonical_topic.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	2026-0912-2307 renders as “09/12/2026”.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	“Opus 5”, matching the frontmatter.
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 holds only the title and the template subline; the ER’s long alternate-names 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	🟢	Mechanism, event benefit, plaque, the mortality caveat, the risk-gradient caveat and the main harm, all drawn from the ER Conclusion.
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 of the six clauses maps to a separate sentence of the ER Conclusion.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; “main cholesterol-carrying particle” stands in for LDL/ApoB and “liver enzyme” for PCSK9.
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 percentages, hazard ratios or confidence intervals; “four to five years” is a follow-up duration, not an effect size.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All six items come from the ER’s “Populations who should avoid PCSK9 Inhibitors” list.
8.2	[stop_items] represent the Contraindications from the ER	🟢	All six ER populations are carried; none omitted, none added.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Six discrete <li> elements inside the span.
8.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	Every ER trailing clause is stripped, including “— no human data, and antibodies cross the placenta”, “a latex-free device exists”, “— the antibodies cannot work without residual receptor activity” and “— untested in this group”.
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).	🟢	“(Child-Pugh Class C)”, “(both LDL receptor genes non-functional)”, “(prefilled syringe and autoinjector presentations)” and “under 10 years” 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 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 six such populations and the section is correspondingly populated.
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 six items come from the ER’s interaction bullet list.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	All interactions that change how the intervention is used are carried; the ER’s “Cytochrome P450-metabolised drugs — no interaction expected” bullet asserts the absence of an interaction and correctly does not populate a decision gate (see 9.7).
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Six discrete <li> elements inside the span.
9.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	The ER’s “— additive, monitor” / “— caution, timing” tails and all mechanistic rationale (monacolin K, berberine receptor upregulation, apheresis timing) are stripped.
9.5	Parenthetical qualifiers from the ER bullet — example drug lists, time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	Named example lists are preserved: “(atorvastatin, rosuvastatin, simvastatin)”, “(red yeast rice, niacin, omega-3 fatty acids, psyllium)”, “(plant sterols and stanols, berberine, soluble fibre, garlic extract)”.
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 several additive combinations and an apheresis timing constraint, and the section is correspondingly populated.
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 come from the ER Therapeutic Protocol dosing bullets.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	The dosing regimens of the three marketed agents; the ER’s fourth agent, enlicitide, is explicitly “not yet a protocol option outside trials” and is correctly excluded.
10.3	If less that three distinct actionable implementation aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	The ER supplies more than three actionable aspects; 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 fields populated; each dose, route and alternative schedule matches the ER bullet exactly.

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	🟢	Cholesterol lowering, event-rate separation and plaque change — the three facts in the ER’s “Time to effect” bullet.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Cholesterol lowering and fewer events are both High-tier benefits and lead; plaque regression is a Low-tier benefit and comes 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 three distinct time-to-effect aspects; 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 fields populated; “1-2 weeks”, “About 1 year” and “18 months” match the ER values, with the inclisiran 30-60 day qualifier retained in the sub-line.
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 retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	All eight items correspond to the eight ER benefit headings across the four tiers.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four 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 tier is a semicolon-separated condensation of ER headings; no Magnitude figures, trial names or funding notes carried across.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No effect sizes, sample notes or study names remain; the only parenthetical, “(conflicted)”, carries the ER’s own evidence-conflict marker required by 1.2 and cannot use the ER’s emoji under 4.4.
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 tiers carry 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 nine items correspond to the nine ER risk headings across the four tiers.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four 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.	🟢	ER headings condensed to bare fragments; no percentages, relative risks, confidence intervals or the bococizumab programme detail.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No frequencies or severity grades remain; the only parenthetical, “(conflicted)”, carries the ER’s own evidence-conflict marker required by 1.2 and cannot use the ER’s emoji under 4.4.
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 tiers carry 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 line come from the ER Monitoring Protocol & Defining Success section.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All ten ER biomarkers present in ER order: ApoB, LDL-C, Lipoprotein(a), Non-HDL cholesterol, Triglycerides, HbA1c, hs-CRP, ALT, Creatine kinase, eGFR, 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.	🟢	Baseline panel, 4-8 week and ~90 day rechecks, then twice-yearly lipids with annual glucose and liver enzymes — matching the ER cadence paragraph.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	All four items come from the ER’s “Qualitative markers worth tracking” list.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All four ER qualitative markers present: injection-site comfort, muscle comfort, energy and cognitive clarity, adherence pattern.

Issues 12/09/2026 23:13

Pass rate 100.00%. No issues found.