Audit: QRS - Periodic Phlebotomy for Health & Longevity

Audit conducted on 10/23/2026 23:02 using AI4L / Opus 5.5

Iterations

Summary

Items Count
Total 94
Passed 84
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. 🟢 All lede, protocol, time, gate, tier and monitoring statements trace to ER text (e.g., Conclusion lines 446–450, Therapeutic Protocol lines 350–354, populations list lines 323–328).
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. 🟢 Hedges kept: lede “remains unproven”; action_3 “later proposed”; marker targets “(proposed)”; time_3 “None established in healthy people”; interactions keep “(theoretical)”.
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”). 🟢  
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. 🟢  
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. 🟢 Only FeAST, WHO and US rules appear, each as in the ER.

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. 🟢  
2.2 The tone of the QRS is expert, accessible, objective, and data-driven 🟢  
2.3 The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor 🟢  
2.4 The QRS avoids language that implies medical or clinical advice 🟢  
2.5 The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” 🟢  
2.6 The QRS never addresses the reader directly — it presents evidence, not guidance 🟢  
2.7 The QRS is written in plain language, avoiding unnecessary medical jargon 🟢 Technical terms (e.g., SGLT2 inhibitors, polycythemia vera, vasovagal) are part of ER labels carried verbatim.
2.8 Information is presented in a concise and very compact manner 🟢  
2.9 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. 🟢  
2.10 The target audience is willing to employ lifestyle and behavioral changes as well as follow protocols that may be inconvenient, costly, or require effort. 🟢  
2.11 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. 🟢  
2.12 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. 🟢  
2.13 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. 🟢 No “anti-aging” wording; lede uses “longevity”.
2.14 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. 🟢  

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” 🟢  
3.2 Every element carrying a data-qrs-var attribute in [qrs_template] is present in the QRS with the same name 🟢 All template variables present; marker_# expanded to 1–11, qualitative_item_# to 1–6.
3.3 Everything outside the data-qrs-var spans — markup, text, styles, comments — is as in the template; spans that no checklist item addresses are left unchanged as well 🟢 Diff against template shows changes only inside data-qrs-var spans, the required display:none on empty benefit tiers, and the filled metadata block.

4. Formatting

# Description Result Comments
4.1 An empty ER section never produces visible empty-state text in the QRS: the corresponding region is hidden or left empty. Phrases such as “None documented in human trials to date” or “Not formally studied” appear only where the ER uses them for a fact the QRS carries over. 🟢  
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. 🟢  
4.3 Labels are not paraphrased, abbreviated, or invented. 🟢  
4.4 The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. 🟢 No emoji found in the QRS.
4.5 The QRS is designed to render on one A4 page. It fails this item only for one of four things: a trailing clause after a dash, an optional gloss, an example list left untrimmed, or a repetition. Nothing else is cut to fit. 🟢 No trailing dash clauses, glosses removed from interaction labels, example lists trimmed to one, no repetition.

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. 🟢  
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. 🟢  
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. 🟢  
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. 🟢 duration value “00:02” is quoted because it contains a colon.
5.5 The filename of the source ER is stated as “er_filename: [er_filename]” 🟢  
5.6 Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]” 🟢 26.10.23 matches 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) 🟢  
5.8 The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]” 🟢  
5.9 The nickname of the AI is the full name without the version number, with all remaining words joined by hyphens (e.g., Opus, Sonnet, Grok, Gemini-Flash, GPT); when the full name has no version number or is “Unknown”, the nickname equals the full name 🟢  
5.10 The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]” 🟢  
5.11 The full name of the AI consists of the model name (the word or words directly before the version number, leaving out the first if there is more than one, e.g., Claude Opus 5.5 → Opus 5.5), the model version number and the variant (if any) as stated in the system prompt or developer instructions of the creating model, with every word capitalized and without product, effort or pricing names (e.g., Opus X.Y, Sonnet X.Y, Grok X.Y, Gemini X.Y Flash, GPT X.Y), the model name alone when the system prompt or developer instructions name a model without a version number (e.g., Grok), or “Unknown” when neither the system prompt nor the developer instructions of the creating model name a model 🟢  
5.12 The filename of the document is stated as “qrs_filename: [filename of this document]” 🟢  

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 &) 🟢 “Periodic Phlebotomy for Health & Longevity - Quick Reference Sheet”
6.2 [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., &amp; for &) 🟢  
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢 2026-1023-2247 → 10/23/2026
6.4 [header_subline_model] is set to [qrs_creator_ai_fullname] 🟢  
6.5 No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker. 🟢  

7. At-A-Glance Section

# Description Result Comments
7.1 [at_a_glance] opens by saying what the intervention is — its kind (e.g., dietary supplement, prescription medication, peptide, plant, procedure, practice) — and what it is used for, in plain language, before any verdict on the evidence 🟢 Opens with “the planned, repeated removal of about half a liter of blood, by donation or prescription, to lower the body’s iron stores”.
7.2 [at_a_glance] is dense, execution-oriented summary of the ER Conclusion section 🟢  
7.3 [at_a_glance] is no longer than 70 words 🟢 67 words.
7.4 Every fact in [at_a_glance] is supported by a distinct passage in the ER. 🟢  
7.5 It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead 🟢  
7.6 It DOES NOT cite specific trials (names, years, sample sizes, p-values) 🟢  
7.7 It DOES NOT cite effect sizes, relative risks, or statistical results 🟢  

8. Contraindications

# Description Result Comments
8.1 The section is derived from the ER Key Interactions & Contraindications section 🟢  
8.2 [stop_items] represent the Contraindications from the ER 🟢 All six ER populations to avoid (lines 323–328) are listed.
8.3 Individual [stop_items] are formatted as <li></li> 🟢  
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. 🟢  
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). 🟢  
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 ER uses no ranking notation in contraindications.
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. 🟢  
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 Section is not empty.

9. Key Interactions

# Description Result Comments
9.1 The section is derived from the ER Key Interactions & Contraindications section 🟢  
9.2 [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications 🟢 All nine ER interactions (lines 311–319) are listed.
9.3 Individual [caution_items] are formatted as <li></li> 🟢  
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. 🟢  
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). 🟢  
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 ER uses no ranking notation in interactions.
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. 🟢  
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 Section is not empty.

10. Protocol

# Description Result Comments
10.1 The section is derived from the ER Therapeutic Protocol section 🟢  
10.2 The three sets of [action] items cover the three most important actionable implementation aspects from that section 🟢  
10.3 If fewer than three distinct actionable implementation aspects are mentioned in the ER, the unused sets are left empty and hidden with style="display:none", not filled with placeholder text or empty-state phrasing. N/A ER names more than three actionable aspects.
10.4 All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from that section. 🟢  

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 🟢  
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢  
11.3 If fewer than three distinct time-to-effect aspects are mentioned in the ER, the unused sets are left empty and hidden with style="display:none", not filled with placeholder text or empty-state phrasing. N/A ER names at least three time-to-effect aspects.
11.4 All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER. 🟢  
11.5 If the ER provides no information on time to effect at all, the whole Time to effect block (its subhead and all three sets) is hidden with style="display:none", not removed: its spans stay in place, empty. N/A ER provides time-to-effect information.

12. Benefits

# Description Result Comments
12.1 The section is derived from the ER Expected Benefits section 🟢  
12.2 Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] 🟢  
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. 🟢  
12.4 Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢  
12.5 If a tier (high, medium, low, speculative) has no items, its span is hidden with style="display:none", not filled with “None documented in human trials to date” or similar empty-state phrasing. 🟢 ER has no High or Medium benefits; both spans hidden with style=”display:none”.

13. Risks

# Description Result Comments
13.1 The section is derived from the ER Potential Risks & Side Effects section 🟢  
13.2 Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] 🟢  
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. 🟢  
13.4 Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢  
13.5 If a tier (high, medium, low, speculative) has no items, its span is hidden with style="display:none", not filled with “None documented in human trials to date” or similar empty-state phrasing. N/A All four risk tiers have items in the ER.

14. Monitoring

# Description Result Comments
14.1 The section is derived from the ER Monitoring Protocol & Defining Success section 🟢  
14.2 All measurable/quantifiable biomarkers from that section are listed, one table row per marker; the template’s # row is the pattern, repeated with # replaced by 1, 2, 3 … in the data-qrs-var names 🟢 All ten ER table markers plus hs-CRP (named in the ferritin row and baseline text) are listed, numbered 1–11.
14.3 [marker_#name] is the marker, [marker#target] its target value or range as given in the ER, [marker#_why] its purpose in a few words; a target the ER does not give is written “Not specified in the ER” 🟢 HFE genotype (“No established target”) and hs-CRP (no target) are written “Not specified in the ER”.
14.4 [monitoring_cadence] is populated with the monitoring cadence/frequency derived from that section. It is not left with placeholder text or empty. 🟢  
14.5 If the ER names no measurable biomarker, the table is hidden with style="display:none" and the single # row is left as in the template N/A ER names measurable biomarkers.

15. Qualitative Assessment

# Description Result Comments
15.1 The section is derived from the ER Monitoring Protocol & Defining Success section 🟢  
15.2 All subjective/qualitative markers from that section are listed, one <li> per marker; the template’s # item is the pattern, repeated with # replaced by 1, 2, 3 … 🟢 All six ER qualitative markers (lines 423–428) listed.
15.3 If the ER names no qualitative marker, the card’s list is hidden with style="display:none" and the single # item is left as in the template N/A ER names qualitative markers.

Issues 10/23/2026 23:02

Pass rate 100.00%. No issues found.

Issues 10/23/2026 22:59

  1. 1.3 — HFE genotyping made unconditional: The Monitoring cadence at line 725 says “HFE genotype once”, while the ER limits genotyping to cases “where ferritin or saturation is high”, turning a conditional indication into a universal test.

Fixes 10/23/2026 22:59

  1. 1.3 — HFE genotyping condition restored: Changed the Monitoring cadence from “HFE genotype once” to “HFE genotype once, where ferritin or saturation is high”, matching the ER’s conditional indication.

Issues 10/23/2026 22:57

  1. 1.2 — Proposed hedge dropped: The Transferrin saturation target at line 627 reads “20–50%” without the ER’s “(DePalma et al., proposed)” qualifier (ER line 412), although the ferritin row from the same source keeps “(proposed)”.
  2. 14.2 — hs-CRP marker missing: The ER Monitoring section names hs-CRP as the inflammation marker paired with ferritin at baseline (ER lines 404, 411), but the Monitoring table (lines 599-710) has no row for it.

Fixes 10/23/2026 22:57

  1. 1.2 — Proposed hedge restored: Changed the Transferrin saturation target from “20–50%” to “20–50% (proposed)”, matching the ER and the ferritin row.
  2. 14.2 — hs-CRP row added: Added Monitoring row 11 “hs-CRP” with target “Not specified in the ER” and why “Inflammation raises ferritin”.

Issues 10/23/2026 22:53

  1. 1.2 — Hedge dropped from ferritin target: marker_2_target (line 616) reads “20–100 ng/mL”, while the ER gives “20–100 ng/mL (DePalma et al., proposed)” (ER line 411); the cautious “proposed” is lost.

Fixes 10/23/2026 22:53

  1. 1.2 — Ferritin target hedge restored: Changed marker_2_target from “20–100 ng/mL” to “20–100 ng/mL (proposed)”, matching the ER’s “(DePalma et al., proposed)” qualifier.

Issues 10/23/2026 22:51

  1. 2.7 — Jargon in contraindication item: The item at line 544 drops the ER’s glosses and keeps “orthostatic hypotension” and “eGFR” (ER: “blood-pressure drop on standing”, “estimated filtration rate”), leaving specialist terms in non-label text.
  2. 4.2 / 4.3 — Protocol labels not verbatim: Protocol labels “Volume per session” (line 442), “Interval” (line 453) and “Ferritin range” (line 464) replace the ER bold labels “Standard unit”, “Blood-service approach” and “Trial approach (FeAST, Zacharski and DePalma)”.

Fixes 10/23/2026 22:51

  1. 2.7 — Plain-language contraindication wording: Replaced “orthostatic hypotension” and “eGFR” in the contraindication item with the ER’s plain wording “blood-pressure drop on standing” and “estimated filtration rate”.
  2. 4.2 / 4.3 — ER bold labels restored: Changed Protocol labels to “Standard unit”, “Blood-service approach” and “Trial approach (FeAST)”, and adjusted values/subs so each cell carries only content from its labeled ER bullet.