Audit: QRS - Pet Ownership to Preserve Cognitive Ability

Audit conducted on 20/09/2026 22:41 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	93
Passed	87
Failed	0
N/A	6
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.	🟢	Every cell traced to the ER: protocol cells to Therapeutic Protocol, time cells to Expected Benefits / Practical Considerations, gates to Key Interactions & Contraindications, tiers to Expected Benefits / Potential Risks & Side Effects, markers to the ER biomarker table.
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.	🟢	No empty-state or hedging phrasing in the ER is contradicted; the ER’s empty Speculative risk tier is handled by display:none as item 13.5 requires.
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”).	🟢	Gate severity is preserved: the ER’s absolute contraindications sit in Contraindications, its cautions in Key Interactions.
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.	🟢	No Benefit- or Risk-Modifying Factor content appears in the gates; the chemotherapy item is placed under Contraindications because the ER itself names it “Absolute contraindication”.
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 identifiers, author names or brand names anywhere in the QRS; all drug names are generic and all appear in the ER’s own interaction bullets.
1.6	The QRS does not introduce new attributions.	🟢	No attributions of any kind in the QRS.

2. Focus, Tone & Audience

#	Description	Result	Comments
2.1	The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing.	🟢	Measured, observational-evidence framing matching 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 gates presented without alarm or exhortation.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Content is stated as evidence and thresholds, not as orders.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperatives directed at a reader; gates are stated as conditions, not instructions.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No “recommended”, “advised”, or “should” constructions in the QRS’s own voice.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the body.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Retained technical terms (hyposplenism, absolute neutrophil count, immunoglobulin E) are decision-bearing gate and biomarker terms carried from the ER.
2.8	Information is presented in a concise and very compact manner	🟢	Every cell is a fragment or single clause; no prose paragraphs outside At-A-Glance.
2.9	It DOES NOT address the reader directly	🟢	Confirmed by full-text scan; no “you”/”your” in the body.
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.	🟢	Monitoring panel of 10 biomarkers and a split-walk protocol address a proactive, self-quantifying audience.
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.	🟢	The protocol presents a twice-daily walking routine and a lifelong care commitment without softening the effort involved.
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.	🟢	Density and biomarker specificity place it well above 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.	🟢	At-A-Glance names the living-alone subgroup where the signal concentrates and states the unresolved confounding directly.
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 in the QRS.
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.	🟢	Clinical register maintained (“absolute neutrophil count”, “sensitisation”, “zoonotic infection”); “cell-killing chemotherapy” is the ER’s own wording.

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 match the template byte for byte.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 38 template variables present; the repeating marker_#_* and qualitative_item_# placeholders are correctly expanded to 10 marker rows and 6 qualitative items.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	Diff against the template shows only variable regions changed; the website="evidence_review", website="audit" and website="full_review" spans, the CSS block, and the footer disclaimer 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	The ER carries no empty-state phrasing; its only empty subsection (Speculative risks) has no text at all and is handled by display:none under item 13.5.
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 “Core regimen”, “Split rather than single exposure” and “Best time of day” are verbatim ER bold labels; interaction bold labels (“Immunosuppressants”, “Tumour necrosis factor inhibitors”, “Oral anticoagulants”, “Sedative-hypnotics and anticholinergic drugs”, “Over-the-counter allergy and pain medication”, “Supplement interactions”, “Supplements with additive effects”) likewise.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Marker names reproduce the ER biomarker table verbatim; tier and gate labels are fixed template strings.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	Zero emoji code points in the file; the ER’s 🟩/🟥/🟨/⚠️/⭕️ markers were correctly stripped.
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.	🟢	Rendered body text is roughly 700 words at 9–11pt inside a 12mm-margin A4 print block; long ER entries (marker 10’s target, the cadence paragraph, the qualitative items) are condensed to fit.

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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 on line 2, directly after the doctype on line 1, and precedes every other 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, closing --- on line 13; the preceding “QRS — Metadata” note sits before 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.	🟢	Enclosed in an HTML comment; no metadata value is echoed into any rendered element except the template-mandated subline date and model.
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: "00:02" is quoted, and it contains a colon that requires it; all other values are bare and trimmed.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	er_filename: pet_ownership_cognitive_2026-0920-1820_Opus_ER.md, matching the ER’s own filename frontmatter value.
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 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)	🟢	qrs_creation_date: 2026-0920-2226 conforms to the required pattern.
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)	🟢	“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]”	🟢	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: pet_ownership_cognitive_2026-0920-1820_Opus_QRS.html matches 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; 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 &)	🟢	“Pet Ownership to Preserve Cognitive Ability - Quick Reference Sheet”; the topic contains no characters needing entity encoding.
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	“Pet Ownership to Preserve Cognitive Ability”, identical to the ER’s canonical_topic.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	2026-0920-2226 → “09/20/2026”.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	“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” 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	🟢	Compresses all three Conclusion paragraphs: the bundled exposure, the cohort signal and its living-alone concentration, the absence of randomisation, and the cost list.
7.2	[at_a_glance] is no longer than 60 words	🟢	Exactly 60 words, at the limit.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Each clause maps to a distinct Conclusion sentence; no synthesised claim.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; vocabulary is “memory and word-finding tests”, “broken bones”, “disturbed sleep”, “grief”.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No study names, years, sample sizes or p-values.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No numeric effect estimates; direction is stated qualitatively (“declining more slowly”).

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All eight items trace to that section — seven from “Populations who should avoid Pet Ownership” plus the chemotherapy bullet the ER labels an absolute contraindication.
8.2	[stop_items] represent the Contraindications from the ER	🟢	Complete coverage of the ER’s avoid-list with nothing added from other ER sections.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Eight 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.	🟢	Rationale clauses stripped (e.g., “because of congenital toxoplasmosis risk” after the pregnancy item, “able to assume animal care” after the dementia item); no trailing dash clauses remain.
8.5	Parenthetical qualifiers from the ER bullet — time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	“within 6 months”, “≥20 mg daily”, “Global Initiative for Asthma step 4–5”, “T-score ≤ −2.5”, “Clinical Dementia Rating ≥2”, “below 500 per microlitre” and “above 15 kg” all retained; only the ER’s definitional glosses were trimmed.
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.	🟢	The ER uses no such ranking notation in this section; the ≥/≤ symbols carried through are numeric thresholds that read unambiguously on their own.
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 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 seven items are ER interaction bullets from that section.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	The chemotherapy bullet is correctly omitted here because it sits in Contraindications; the “Other intervention interactions” bullet (“No restriction”) is correctly omitted as imposing no change in use.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Seven 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.	🟢	Consequence and mitigation clauses stripped from every bullet; no trailing dash clauses remain.
9.5	Parenthetical qualifiers from the ER bullet — example drug lists, time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	Every named example drug is preserved, along with the “≥20 mg daily for ≥2 weeks” threshold and the “for litter handling” scope qualifier.
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.	🟢	The ER uses no ranking notation here; drug examples are rendered as plain comma-separated lists.
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 identifies such interactions 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 derive from the ER’s Therapeutic Protocol section.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	The ER’s first three bullets — core regimen, split exposure, best time of day — are the actionable ones; the remaining bullets describe competing approaches and modifying factors.
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 three or more actionable aspects and 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: “30 min daily dog walking”, “2 bouts of 15–20 min” and “Within 2 h of waking” with ER-derived sublines.

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	🟢	Verbal memory and fluency, disabling dementia, and walking volume/routine — the three endpoints for which the ER gives a time horizon.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Both Medium-tier benefits precede the Low-tier walking-volume benefit.
11.3	If less that three distinct time-to-effect aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	The ER supplies three distinct time-to-effect aspects and 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.	🟢	“8–13 years” matches the ER’s “eight to thirteen years of follow-up”; “4 years” matches the Japanese cohort window; “2–4 weeks” matches the ER’s Practical Considerations time-to-effect bullet.
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 and the section is retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	Every listed benefit corresponds to an ER Expected Benefits subsection heading.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present and correctly assigned to their tiers.
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.	🟢	Condensed heading phrases only; no magnitudes, confidence intervals, cohort descriptions or mechanistic prose.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any benefit item.
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.	🟢	benefits_high is set to display: none and emptied, matching the ER’s “No benefit reaches High”.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	All eight listed risks correspond to ER Potential Risks & Side Effects subsection headings.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present and correctly assigned to their tiers.
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.	🟢	Condensed heading phrases only; injury counts, odds ratios and study designs are all stripped.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any risk item.
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.	🟢	Both risks_high and risks_speculative are set to display: none and emptied, matching the ER’s empty High and Speculative tiers.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	All ten rows derive from the ER’s Monitoring Protocol & Defining Success biomarker table.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All ten ER table rows are present in order, with names verbatim and targets preserved.
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.	🟢	Reproduces the ER’s ongoing-monitoring tempo: step count and sleep continuously or monthly, blood pressure every 3 months, cognitive and mobility measures at 12 months then annually, bone density every 2 years where abnormal at baseline.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	All six items come from the ER’s “Qualitative markers worth tracking alongside the measured ones” list.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All six ER qualitative markers present, in the ER’s own order.

Issues 20/09/2026 22:41

Pass rate 100.00%. No issues found.

Issues 20/09/2026 22:30

1. 4.5 — One-page budget exceeded: Estimated render is close to two A4 pages: 8 multi-line contraindications (lines 550–557), 7 multi-line key interactions (lines 565–571), a 10-row Monitoring table whose Marker and Why cells wrap to two lines (lines 615–724), 6 Qualitative items (lines 737–754), and Protocol/Time sub-cells that each wrap to three lines (lines 450, 461, 472, 489, 511).

Fixes 20/09/2026 22:30

1. 4.5 — Protocol and Time sub-cells shortened: Condensed all six sub-cells so each wraps to two lines instead of three, e.g. action_1_sub from “Temperament-assessed adult animal matched to household mobility, plus a fixed daily care routine” to “Temperament-assessed animal matched to household mobility; fixed care routine”, and time_3_sub from “Walking volume and daily routine change after acquisition; no study has detected a cognitive change over months” to “Walking and routine change; no cognitive change detected over months”.
2. 4.5 — Contraindication items condensed: Trimmed four of the eight stop_items by one rendered line each while keeping every threshold and scope qualifier, e.g. “Advanced dementia (Clinical Dementia Rating ≥2) without a co-resident caregiver able to assume animal care” to “…without a co-resident caregiver”.
3. 4.5 — Key Interaction items condensed: Shortened the over-the-counter entry to the ER’s own example drug “ibuprofen” in place of “non-steroidal anti-inflammatory drugs”, and dropped “extracts” from the additive-effects supplement list.
4. 4.5 — Monitoring Why column condensed: Rewrote nine of the ten “Why” cells to single-line length, e.g. “Quantifies allergic sensitisation driving airway inflammation and sleep fragmentation” to “Allergic sensitisation driving airway inflammation and poor sleep”; all ten markers and their targets are retained.
5. 4.5 — Benefits, Risks and Qualitative items tightened: Removed redundant words from benefits_medium, benefits_speculative, risks_low and qualitative_item_6 to drop one rendered line each, e.g. “sleep disruption from bed-sharing with a pet” to “sleep disruption from bed-sharing”.