Audit: QRS - Progesterone for Health & Longevity

Audit conducted on 12/09/2026 09:01 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.	🟢	Protocol cells, time-to-effect cells, gate items, benefit/risk tiers, all 8 monitoring rows, cadence and the 5 qualitative items each trace to a specific ER passage.
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.	🟢	“unproven during the transition” (time_3_sub) and “No established on-therapy target” (marker_2_target) mirror ER lines 171 and 440.
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”).	🟢	“Safety evidence reassures to five years and thins beyond” matches ER line 478; contraindications retain absolute framing.
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.	🟢	stop_items come only from the ER “Populations who should avoid Progesterone” list; caution_items only from the ER interaction bullets.
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, citations, expert names, NCT identifiers or brand names appear anywhere in the QRS.
1.6	The QRS does not introduce new attributions.	🟢	No attributions of any kind are present.

2. Focus, Tone & Audience

#	Description	Result	Comments
2.1	The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing.	🟢	Measured, non-promotional register carried over from the ER, including its net statements on hot flushes and bone.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Actionable protocol and monitoring panels paired with plain-language framing.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Regimens are described as validated options, not instructions.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperatives; all cells are declarative statements of evidence.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No recommending or advising verbs present.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the document.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms retained are load-bearing decision-gate terms carried from the ER; no gratuitous jargon added.
2.8	Information is presented in a concise and very compact manner	🟢	All cells are fragment-length; no elaboration or rationale carried into the gates or tiers.
2.9	It DOES NOT address the reader directly	🟢	Confirmed — no direct address in any span.
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.	🟢	Functional monitoring targets and a five-year continuation framing address exactly this 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.	🟢	Nightly dosing, daily symptom scoring and an 8-marker panel assume high adherence.
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.	🟢	No simplification toward general-population framing.
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 cream-versus-capsule distinction and the beyond-five-years risk are both surfaced prominently.
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.	🟢	benefits_speculative reads “Broader slowing of aging processes”; the string “anti-aging” does not occur.
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 capsules”, “200 mg oral, bedtime”, “transdermal” used throughout; no “pill”, “shot” or “taken by mouth”.

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 headings byte-identical to the template (lines 440, 477, 519, 539, 553, 573, 592, 596-598, 700).
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 33 named template variables present; the repeatable marker_# and qualitative_item_# patterns instantiated as marker_1–8 and qualitative_item_1–5.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	A normalized diff against the template shows changes only inside data-qrs-var spans and the metadata block; the website=”evidence_review” / “audit” / “full_review” spans, CSS and 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 mapped by this checklist 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.	🟢	“Standard cyclic regimen”, “Standard continuous regimen”, “Progesterone-alone regimen for symptoms” are the ER’s bold labels verbatim (ER lines 348-352); monitoring row labels match the ER table verbatim.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Time-to-effect labels (“Endometrial protection”, “Sleep changes”, “Hot-flush reduction”) are lifted verbatim from ER line 405.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	Zero emoji characters in the file; tiers are rendered via bold labels and CSS palettes.
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.	🟢	Every section is condensed to fragment length; the ER’s 8-marker table and 5 qualitative markers are carried at minimum wording.

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5. Metadata

#	Description	Result	Comments
5.1	The metadata is placed inside a single HTML comment that is the first element after “<!doctype html>” and before any other comment, head, or body content.	🟢	Lines 2-14; first element after the doctype on line 1.
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, closing “—” at line 13.
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 repeated in head or 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.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	Line 4: er_filename: progesterone_2026-0912-0602_Opus_ER.md.
5.6	Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]”	🟢	Line 5: qrs_prompt_version: 26.9.11, matching the 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)	🟢	Line 6: qrs_creation_date: 2026-0912-0839.
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢	Line 7: qrs_creator_ai_nickname: Opus.
5.9	The nickname of the AI is just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT)	🟢	“Opus” — single word, no version.
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢	Line 8: qrs_creator_ai_fullname: Opus 5.
5.11	The full name of the AI consists of the [qrs_creator_ai_nickname] and the model version number and no additional qualifier (e.g., Opus 4.6, Sonnet 3.2, Grok 4.5, Gemini 3.1, ChatGPT 5.4)	🟢	“Opus 5” — nickname plus version, no qualifier.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	Line 9: qrs_filename: progesterone_2026-0912-0602_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.	🟢	All nine keys carry single-space-delimited, untrimmed-whitespace-free values.

6. Page Title & Header

#	Description	Result	Comments
6.1	[page_title] is set to the [canonical_topic] of the ER frontmatter followed by “ - Quick Reference Sheet” (e.g., “Intervention - Quick Reference Sheet”). The [canonical_topic] is HTML-entity-encoded as needed (e.g., & for &)	🟢	Line 22: “Progesterone 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 &)	🟢	Line 417: “Progesterone for Health & Longevity”.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	Line 421: “09/12/2026” from qrs_creation_date 2026-0912-0839.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	Line 425: “Opus 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.	🟢	Header contains only the title and the template subline; no AKA line despite the ER carrying seven alternate names.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Line 433 condenses ER lines 476-478: bioidentical framing, route-dependent endometrial protection, sleep, hot flushes, five-year safety horizon, trade-offs.
7.2	[at_a_glance] is no longer than 60 words	🟢	59 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Each of the five sentences maps to a distinct clause in the ER Conclusion.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; “uterine lining”, “hot flushes”, “final period” used in place of endometrium, vasomotor symptoms, menopause.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial names, years, sample sizes or p-values.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No numeric effect estimates; “five years” is a duration, not a statistic.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All seven items trace to ER lines 321-326.
8.2	[stop_items] represent the Contraindications from the ER	🟢	The ER’s six “Populations who should avoid Progesterone” bullets are fully represented, with the combined pregnancy/porphyria bullet split into two items.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Lines 542-548: seven well-formed <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.	🟢	ER glosses (“the most advanced grade of chronic liver failure”, “a rare inherited disorder of pigment-precursor metabolism”) are stripped; no dashes introduce trailing clauses.
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 C)”, “within 12 months”, “above 3× upper limit of normal” and “until malignancy is excluded” 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 contraindication bullets use no ranking notation.
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 eight items trace to ER lines 301-315.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	All eight pharmacological interaction bullets carried; the ER’s ninth bullet is explicitly “No pharmacological interaction” and is correctly not surfaced as a gate.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Lines 556-563: eight well-formed <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.	🟢	Caution/Monitor labels, mechanism sentences and Mitigation clauses from the ER are all stripped; no dashes carry trailing content.
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 ER bullet that carried example drugs retains a shortened list (rifampin/carbamazepine/St John’s wort, ketoconazole/ritonavir/grapefruit juice, lorazepam, zolpidem, pregabalin, diphenhydramine, levothyroxine, amlodipine, spironolactone).
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 interaction bullets use no ranking notation.
9.7	The section is left empty ONLY IF the ER’s Key Interactions & Contraindications section identifies no interaction, additive effect, or exposure that changes how the intervention is used.	🟢	The ER names multiple 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 ER “Therapeutic Protocol” lines 348-352.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Cyclic 200 mg, continuous 100 mg and progesterone-alone 300 mg are the ER’s three dosing regimens; the competing-approach and attribution bullets are correctly not treated as regimens.
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 provides three distinct 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 spans carry ER-derived content; no placeholders remain.

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	🟢	Endometrial protection, sleep changes and hot-flush reduction are exactly the three named in ER line 405.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Endometrial protection and sleep are the ER’s two High-tier benefits, hot flushes its Medium-tier benefit; the order follows.
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 provides 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.	🟢	“Immediate”, “First night” and “4–12 weeks” with ER-derived subs; no placeholders remain.
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 at line 405; the section is correctly retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	Tier membership matches ER lines 153-205 exactly.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present and populated (lines 521-532).
12.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢	Each entry is the ER benefit heading reduced to a noun phrase; no Magnitude figures or “⚠️ Conflicted” markers carried over.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any benefits span.
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	The ER populates all four tiers.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	Tier membership matches ER lines 229-281 exactly, including all four High-tier entries.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present and populated (lines 575-586).
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.	🟢	“Bleeding, Spotting and Headache Driving Discontinuation” reduced to “bleeding, spotting and headache”; no frequencies or Magnitude figures carried.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any risks span.
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	The ER populates all four tiers.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Rows mirror the ER “Monitoring Protocol & Defining Success” table at lines 437-446.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All 8 ER table rows carried: endometrial thickness, serum progesterone, estradiol, TSH/free T4, HDL-C/LDL-C, fasting glucose/HbA1c, ALT/AST, blood pressure.
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.	🟢	Line 694 condenses ER lines 433-435: baseline, 4 weeks, 8–12 weeks, 6 months, then 6–12 months, plus event-driven imaging.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	Items taken from the ER qualitative-marker list at lines 450-454.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All 5 ER qualitative markers carried verbatim: sleep onset/awakenings, hot-flush frequency and intensity, next-morning alertness, mood stability, breast tenderness/bloating/bleeding.

Issues 12/09/2026 09:01

Pass rate 100.00%. No issues found.

Issues 12/09/2026 08:54

1. 4.5 — Sheet overruns one A4 page: Estimated rendered height is roughly 1.7 A4 pages against the template’s ~273 mm usable print area. The largest overruns are the two decision-gate columns (QRS lines 541–564), which carry the ER’s five-item parenthetical drug lists near-verbatim at ~16 wrapped lines per column, the three protocol sub-cells at ~5 wrapped lines each in a one-third-width column (lines 450, 461, 472), the three-line benefits_medium and risks_high entries (lines 525, 576), the full-sentence marker_2_target (line 618) and the three-line monitoring_cadence (line 694).

Fixes 12/09/2026 08:54

1. 4.5 — Contraindication items condensed: Trimmed the five longest stop_items (QRS lines 542–548) — e.g. “Active venous thromboembolism or arterial thromboembolic disease; stroke or myocardial infarction within the past 12 months” to “Active venous or arterial thromboembolism; stroke or myocardial infarction within 12 months”, and “Severe liver impairment (Child-Pugh Class C) or active liver disease with liver enzymes above three times the upper limit of normal” to “Severe liver impairment (Child-Pugh C), or liver enzymes above 3× upper limit of normal”. All severity classes, thresholds and time windows retained; the column drops from ~15 to ~12 wrapped lines.
2. 4.5 — Interaction drug lists trimmed: Shortened the parenthetical example lists in caution_items (QRS lines 556–563) to two or three representative agents per class — e.g. CYP3A4 inducers from five named drugs to “rifampin, carbamazepine, St John’s wort” — so no class loses its examples entirely. The column drops from ~16 to ~14 wrapped lines.
3. 4.5 — Protocol sub-cells condensed: Cut all three action_#_sub spans (QRS lines 450, 461, 472) by roughly a quarter, dropping restatable framing (“the dose-days combination validated for…” to “validated for…”, “at the cost of irregular spotting” to “irregular spotting”), taking each one-third-width cell from ~5 to ~4 wrapped lines.
4. 4.5 — Benefits and risks tier lines shortened: Removed the duplicated “compared with synthetic progestins” from benefits_medium (line 525) and the “driving discontinuation” elaboration from risks_high (line 576), taking each entry from three wrapped lines to two.
5. 4.5 — Monitoring table and cadence tightened: Shortened marker_2_target to “No established on-therapy target; track against own pre-treatment value” (line 618) and monitoring_cadence to drop redundant wording (line 694), saving a wrapped line in each.

Issues 12/09/2026 08:48

1. 11.4 — Time-to-effect sub restates value: [time_3_sub] at line 511 reads “Builds over four to twelve weeks.”, which is a word-for-word restatement of [time_3_value] “4–12 weeks” at line 508 and therefore carries no meaningful content of its own.

Fixes 12/09/2026 08:48

1. 11.4 — Time-to-effect sub restates value: Replaced [time_3_sub] “Builds over four to twelve weeks.” with “Established after the final period; unproven during the transition.”, so the sub adds the ER’s own hot-flush caveat instead of repeating the “4–12 weeks” value.