Audit: QRS - Phosphorus for Health & Longevity

Audit conducted on 24/09/2026 07:54 using AI4L / Opus 5.5

Iterations

Summary

Items	Count
Total	94
Passed	88
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.	🟢	All values, labels and items trace to the ER (Therapeutic Protocol, Practical Considerations, Expected Benefits, Potential Risks, Key Interactions, Monitoring 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.	🟢	Cautious wording kept (e.g., “Caution to avoid”, “No established target; track change from own baseline”)
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”).	🟢	No strengthening or softening; burosumab + oral phosphate kept as a contraindication, matching the ER’s “Absolute contraindication”
1.4	The QRS does not relabel an ER fact under a different decision category. A “Benefit-Modifying Factor” from ER section is not surfaced as a “Caution”; a “Risk-Modifying Factor” is not surfaced as a “Side Effect”; etc.	🟢	Benefits, risks, contraindications and interactions map to their ER categories; modifying factors are not relabeled
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 or brand names appear on the sheet
1.6	The QRS does not introduce new attributions.	🟢	No attributions introduced

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.	🟢	Neutral, evidence-weighted tone matches the ER
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Lede is data-driven and ends on a reassuring note (“Moderate whole-food intake carries little risk”)
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”	🟢	Protocol cells describe approaches (“Limits additive phosphates…”) rather than instruct
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person address found
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms expanded (eGFR, NYHA, NSAIDs, PTH, FGF23, ileus, ascites)
2.8	Information is presented in a concise and very compact manner	🟢
2.9	It DOES NOT address the reader directly	🟢
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.	🟢
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.	🟢	Restriction approach and monitoring cadence assume a proactive, effort-willing reader
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.	🟢
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.	🟢	Lede frames the question for this audience as avoiding excess rather than supplementing
2.14	The document’s own voice frames usage in longevity terms, not “anti-aging” (e.g., “anti-aging clinics”, “anti-aging community”, “anti-aging medicine”). Proper names that contain “anti-aging” (e.g., “American Academy of Anti-Aging Medicine”) are quoted verbatim.	🟢	“Longevity” framing used; no “anti-aging”
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.	🟢	“Oral” used; no lay route or colloquial terms found

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 table headers unchanged
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All template data-qrs-var spans present; marker_# and qualitative_item_# instantiated 1–9 and 1–6
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	Template-only spans (website=”evidence_review”, “audit”, “full_review”) unchanged; diff against template shows only variable content

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”	🟢	Empty ER tiers (Benefits High, Speculative) handled per 12.5; no other mapped ER section is empty
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 (“Dietary baseline”, “Phosphate-conscious diet (restriction approach)”, “Repletion protocol (supplementation approach)”) and interaction labels are verbatim ER bold labels
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 indicators
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.	🟢	Sections condensed (interaction items reduced to verdicts, benefit/risk items to headlines)

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.	🟢	Metadata comment is line 2, directly after <!doctype html>
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 “00:00” is quoted because it contains a colon; other values are unquoted and trimmed
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]”	🟢	26.9.23 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)	🟢	2026-0924-0735
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 just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT)	🟢
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 [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)	🟢
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢
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.	🟢

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 &)	🟢	“Phosphorus 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., & for &)	🟢
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	09/24/2026
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	Opus 5.5
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 “an essential dietary mineral … also sold as phosphate salt supplements to correct deficiency or aid endurance”
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	🟢	68 words
7.4	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Facts trace to ER Conclusion and Motivation
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 8 ER “Populations who should avoid” items plus the ER’s absolute contraindication (burosumab with oral phosphate)
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).	🟢	eGFR threshold/stage, serum thresholds, NYHA class, age threshold and product scope kept
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.	🟢	No ranking notation in ER
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.	🟢	Section populated; ER names populations to avoid
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	Section 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	🟢	Burosumab + oral phosphate listed as a contraindication; caution item for this ER bullet addresses calcitriol only
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.	🟢	Rationales and mitigations 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).	🟢	Example drug lists preserved
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.	🟢
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.	N/A	Section not empty

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Dietary baseline, restriction approach and repletion protocol
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	ER provides more than three actionable aspects
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol 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	🟢	Weight effects, repletion, performance loading (ER Practical Considerations)
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Weight (Medium benefit) first, then repletion and loading (Low; loading conflicted)
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	ER gives three or more 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 does not provide any information on time to effect, the section is removed completely from the Protocol Panel	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 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 and benefits_speculative set to 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 no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	N/A	All four risk tiers have ER items

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All 9 ER table biomarkers listed
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.	🟢

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All 6 ER qualitative markers listed

Issues 24/09/2026 07:54

Pass rate 100.00%. No issues found.

Issues 24/09/2026 07:50

1. 2.7 — Unexplained jargon in Benefits/Risks: “osteomalacia” (line 525), “Acute phosphate nephropathy”, “nephrocalcinosis” and “hyperparathyroidism” (line 582) and “FGF23-driven” (line 588, first use, expanded only later at line 631) appear without plain-language explanation, although the ER supplies one for each.

Fixes 24/09/2026 07:50

1. 2.7 — Replaced unexplained jargon: Used the ER’s own plain-language wording instead: “osteomalacia” became “soft, poorly mineralized bones”, “Acute phosphate nephropathy” became “Acute kidney injury”, “nephrocalcinosis and hyperparathyroidism” became “calcium deposits in kidney tissue and overactive parathyroid glands”, and “FGF23-driven heart muscle thickening” became “Heart muscle thickening driven by FGF23, a bone-made hormone”.

Issues 24/09/2026 07:48

1. 2.7 — NYHA acronym not expanded: Line 544 contraindication “Heart failure (NYHA Class III–IV, severe-symptom classes)” leaves NYHA unexpanded; the ER’s expansion “the New York Heart Association’s” was trimmed.

Fixes 24/09/2026 07:48

1. 2.7 — NYHA acronym expanded: Restored the ER expansion in the heart failure contraindication, from “NYHA Class III–IV, severe-symptom classes” to “NYHA Class III–IV, the New York Heart Association’s severe-symptom classes”.

Issues 24/09/2026 07:44

1. 2.7 — Unglossed specialist terms and abbreviations: Contraindications use “eGFR” (line 542), “NYHA Class III–IV” (line 544) and “Familial tumoral calcinosis or hypoparathyroidism” (line 548) without the plain-language glosses the ER provides; Monitoring markers “eGFR”, “PTH” and “FGF23 (intact)” (lines 616, 621, 631) are unexpanded abbreviations.

Fixes 24/09/2026 07:44

1. 2.7 — Glossed specialist terms and abbreviations: Added ER-derived plain-language glosses to the Contraindications (“eGFR (a measure of kidney filtering)”, “NYHA Class III–IV, severe-symptom classes”, “tumoral calcinosis (phosphate-driven calcium deposits)”, “hypoparathyroidism (underactive parathyroid glands)”). Expanded the Monitoring marker names for eGFR, PTH (parathyroid hormone) and FGF23 (fibroblast growth factor 23, a bone-made hormone).

Issues 24/09/2026 07:41

1. 2.7 — Contraindication jargon left unexplained: The Contraindications items (QRS lines 543-545) use “hypercalcemia”, “ascites”, “ileus” and “active colitis” without the short plain-language glosses the ER bullets provide (ER lines 300-302: “high blood calcium”, “fluid in the abdomen”, “stalled bowel movement”, “inflamed colon”).

Fixes 24/09/2026 07:41

1. 2.7 — Contraindication jargon glossed: Restored the ER’s plain-language glosses in the Contraindications items: “hypercalcemia (high blood calcium; …)”, “ascites (fluid in the abdomen)”, “ileus (stalled bowel movement)” and “active colitis (inflamed colon)”.

Issues 24/09/2026 07:38

1. 4.2 / 4.3 — Labels not verbatim from ER: The interaction label “Active vitamin D (calcitriol, alfacalcidol)” (line 563) trims the ER bold label “Burosumab and active vitamin D (calcitriol, alfacalcidol)”; action_2_label “Phosphate-conscious diet” and action_3_label “Repletion protocol” (lines 455, 466) drop the ER label parentheticals “(restriction approach)” and “(supplementation approach)”.
2. 9.4 — Trailing explanations in interactions: Caution items carry explanatory clauses after the action word (“monitor; cut phosphate absorption”, line 561; “monitor; causes low phosphate in most recipients”, line 562; “monitor; lower absorption of both”, line 565), and the active vitamin D item (line 563) gives only mechanistic rationale (“increases phosphate absorption and urine calcium”) instead of the key action.

Fixes 24/09/2026 07:38

1. 4.2 / 4.3 — Labels restored to ER wording: Restored the ER bold labels verbatim: “Burosumab and active vitamin D (calcitriol, alfacalcidol)”, “Phosphate-conscious diet (restriction approach)” and “Repletion protocol (supplementation approach)”.
2. 9.4 — Trailing explanations stripped: Reduced the antacid/binder, intravenous iron and calcium/magnesium/iron items to “monitor”, and replaced the active vitamin D mechanism text with the ER action “monitor urine calcium with calcitriol”.