Audit: QRS - PT-141 for Health & Longevity

Audit conducted on 10/08/2026 02:18 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	91
Passed	81
Failed	0
N/A	10
Pass Rate	100.00%

• Total = Passed + Failed + N/A
• Pass Rate = Passed / (Passed + Failed) × 100
• N/A items are excluded from the pass rate calculation

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1. General Rules

#	Description	Result	Comments
1.1	Every claim, magnitude, label, recommendation, and statement in the QRS is literally supported by content in the source ER.	🟢	All protocol, gate, tier, marker and qualitative strings trace to the ER (Therapeutic Protocol, Key Interactions & Contraindications, Expected Benefits, Potential Risks & Side Effects, Monitoring Protocol & Defining Success, Practical Considerations, Conclusion).
1.2	Where the ER uses cautious phrasing (“not formally studied”, “None documented in human trials to date”, “theoretical concern”, “data are limited”), the QRS uses the same phrasing.	🟢	The contested nature of the desire finding is carried into [at_a_glance] (“Whether that change matters in daily life is contested”), mirroring the ER Conclusion.
1.3	The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”).	🟢	Contraindications retain absolute framing; pregnancy, breastfeeding and oral naltrexone remain in the stop gate rather than the caution gate.
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.	🟢	Gates draw only from Key Interactions & Contraindications; nothing from Benefit-Modifying Factors or Risk-Modifying Factors is surfaced in the gates or the risk tiers.
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 appear anywhere in the QRS; named drugs in the caution gate (sildenafil, semaglutide, melanotan II, etc.) are all ER-listed for the same interaction.
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 matching the ER throughout.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Targets and cadences are given as actionable data without hedging or alarm.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Protocol cells state what the label and trials establish rather than issuing instructions.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperatives directed at a reader; “discontinue” from the ER is rendered as the descriptive “use ends after 8 weeks without symptom improvement”.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No occurrences of recommend/advise/should/must in document text.
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 gates (eGFR threshold, Child-Pugh Class C, NYHA Class III–IV); no gratuitous jargon.
2.8	Information is presented in a concise and very compact manner	🟢	Tier lines are semicolon-joined ER headings; gate items are stripped to the key fact plus qualifier.
2.9	It DOES NOT address the reader directly	🟢	Confirmed — no direct address.
2.10	The target audience is health- and longevity-oriented adults who are risk-aware, proactive, and actively seeking to optimize health or apply the intervention under review.	🟢	Optimal functional ranges (ApoB < 80 mg/dL, hs-CRP < 1.0 mg/L, TSH 0.5–2.0 mIU/L) rather than conventional laboratory cut-offs.
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 11-marker baseline panel and the 2/4/8-hour first-dose blood-pressure schedule assume that willingness.
2.12	The document is NOT written for the general population, who are unwilling to employ lifestyle and behavioral changes or follow protocols that may be inconvenient, costly, or require effort.	🟢	Content depth and marker breadth are well beyond 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.	🟢	[at_a_glance] flags the contested clinical meaningfulness and the unverified grey-market supply, which is the decision-relevant signal for this audience.
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.	🟢	No occurrence of “anti-aging” or “anti-ageing” 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)”; “injection” not “shot”; “adverse event” not “bad reaction”). Direct quotes from sources are exempt.	🟢	“subcutaneous”, “autoinjector”, “myocardial infarction”, “injection site” used throughout; no colloquialisms 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”	🟢	Structural diff against [qrs_template] shows every fixed heading, gate heading, tier label and column header byte-identical.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 38 template variables present; the repeatable marker_#_* and qualitative_item_# spans are correctly expanded to 11 and 7 instances respectively.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	The three non-variable spans (website="evidence_review", website="audit", website="full_review") are unchanged; no unaddressed variable span was modified.

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 that feeds the QRS 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.	🟢	All seven qualitative items reproduce the ER’s bold lead phrases verbatim (e.g., “Frequency of spontaneous sexual thoughts or interest”, “Any new or changing pigmented patch”).
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Monitoring row labels reproduce the ER biomarker names verbatim; protocol/time cell labels name the aspects decomposed from the ER Therapeutic Protocol bullets as required by 10.2/11.1.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji present; the ER’s “⚠️ Conflicted” markers on the two High benefits are correctly dropped.
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 rather than extended: the ER monitoring table’s fourth “Context/Notes” column is dropped, interaction bullets are stripped of their Severity/Consequence/Mitigation clauses, and benefit/risk items are reduced to bare headings.

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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.
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 the header, footer 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: "00:04" is quoted, and it contains a colon.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	er_filename: pt_141_2026-0810-0033_Opus_ER.md (line 4).
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: 26.7.02 matches the QRS.md version badge.
5.7	Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430)	🟢	qrs_creation_date: 2026-0810-0147.
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” — 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]”	🟢	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]”	🟢	qrs_filename: pt_141_2026-0810-0033_Opus_QRS.html matches the file on disk.
5.13	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	Re-verified: no stray whitespace, no unnecessary quoting on any key.

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 &)	🟢	“PT-141 for Health & Longevity - Quick Reference Sheet” (line 22), correctly entity-encoded.
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	“PT-141 for Health & Longevity” (line 417).
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	2026-0810-0147 → “08/10/2026” (line 421).
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	“Opus 5” (line 425).
6.5	No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker.	🟢	The header contains only the template’s title and subline; the ER’s “Also known as” line is not carried over.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Compresses both Conclusion paragraphs: mechanism and uniqueness, the desire/distress effect and its contested meaning, nausea, and unverified supply.
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 clause maps to the ER Conclusion (lines 506 and 508).
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; “hypoactive sexual desire disorder” is rendered as “women who have not reached menopause” with low desire, and “grey market” as “sold outside pharmacies”.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial names, years or sample sizes.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	Only the qualitative “modest rise” and “matching fall”; no numbers.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All eight items derive from the “Populations that should avoid PT-141” and “Oral naltrexone — absolute avoidance” bullets (ER lines 335, 353).
8.2	[stop_items] represent the Contraindications from the ER	🟢	All eight ER-listed excluded populations are present and none is omitted.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Eight discrete <li> elements (lines 576–583).
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.	🟢	No trailing dash clauses; the ER’s inline glosses (“(heart attack)”, “a calculated measure of kidney filtering capacity”, “the most impaired grade on the standard liver-severity score”) are stripped.
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).	🟢	Retains “(persistently above roughly 140/90 mmHg, or any reading above 160/100 mmHg)”, “(eGFR below 30 mL/min/1.73 m²)”, “(Child-Pugh Class C)”, “Class III–IV”, and the “alcohol or opioid dependence” qualifier on naltrexone.
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 Key Interactions & Contraindications section uses no ranking notation inside parentheses.
8.7	If no [stop_items] are present the section is left empty	N/A	[stop_items] are present.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All nine items map to ER interaction bullets (lines 337–351).
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	Oral naltrexone is correctly excluded here and placed in the stop gate; the ER’s combined “decongestants and analgesics” bullet is split into its two distinct drug classes.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Nine discrete <li> elements (lines 591–599).
9.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	The ER’s “— caution” / “— monitor” / “— avoid” suffixes and the Severity/Consequence/Mitigation prose are all stripped.
9.5	Parenthetical qualifiers from the ER bullet — example drug lists, time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	Named example drugs preserved for every item (amoxicillin/doxycycline/indomethacin; pseudoephedrine/phenylephrine/oxymetazoline; ibuprofen/naproxen/aspirin; ACE inhibitors/ARBs/CCBs/thiazides; the four PDE5 inhibitors; the four melanocortin agonists; semaglutide/tirzepatide; the five pressor supplements).
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 Key Interactions & Contraindications section uses no ranking notation inside parentheses.
9.7	If no [caution_items] are present the section is left empty	N/A	[caution_items] are present.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	All three cells derive from the ER Therapeutic Protocol bullets “Standard approved protocol”, “Best time of day” and “Single versus split dosing” (lines 379–389).
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Dose & route, timing, and frequency ceiling — the three decisions the label and trials actually fix.
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	Three or more distinct actionable aspects are present in the ER; 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 populated; “1.75 mg subcutaneous”, “≥ 45 min before activity” and “Maximum 8 doses per month” all match the ER verbatim in substance.

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	🟢	Per-dose onset, the 8-week stopping point, and the 8–24 week fair personal trial — the three time facts the ER gives (lines 379, 374, 432).
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Onset of the High-tier desire/arousal effect first, then the label-directed decision point, then the full trial window.
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	Three distinct time-to-effect aspects are present in the ER; all three sets are used.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢	All nine spans populated; “45 min – few hours”, “8 weeks” and “8–24 weeks” match ER lines 432 and 374.
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 in Practical Considerations.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	All nine benefit items correspond one-to-one with the ER’s nine Expected Benefits sub-headings.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present and populated, tier for tier with the ER.
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.	🟢	Bare ER headings, semicolon-joined; all Magnitude: lines and the “⚠️ Conflicted” qualifiers are dropped.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses remain 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.	N/A	All four tiers have items in the ER.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	All twelve risk items correspond one-to-one with the ER’s twelve Potential Risks & Side Effects sub-headings.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present and populated, tier for tier with the ER.
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.	🟢	Bare ER headings, semicolon-joined; frequencies such as “40.0% versus 1.3%” and “NNH of 6” are all dropped.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses remain 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.	N/A	All four tiers have items in the ER.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Derived from the ER Monitoring Protocol & Defining Success biomarker table (lines 458–470).
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All 11 ER table rows are present, with Optimal Functional Range and Why Measure It? reproduced into the Target and Why columns.
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 cadence paragraph (line 456) in full: first-dose 2/4/8-hour readings, 4-week review, 8-week reassessment, 3-month chemistry, quarterly BP, 6–12 month panel, annual skin review.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	Derived from the ER’s qualitative-marker bullets (lines 474–480).
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All 7 ER qualitative markers present, with the ER’s bold lead phrases preserved and the trailing rationale clauses stripped.

Issues 10/08/2026 02:18

Pass rate 100.00%. No issues found.

Issues 10/08/2026 02:10

1. 2.15 — Colloquial abbreviation “Max”: action_3_value at line 480 reads “Max 8 doses per month”; the abbreviation is consumer-grade rather than formal clinical register, and the ER (line 379) states “no more than 8 doses per month”.
2. 4.2 — Antihypertensives label shortened: The caution_items entry at line 594 reads “Antihypertensives (…)” instead of the ER’s verbatim bold label “Antihypertensives and other blood-pressure-lowering agents” (ER line 341), narrowing the stated scope of the interaction.

Fixes 10/08/2026 02:10

1. 2.15 — Colloquial abbreviation “Max”: action_3_value changed from “Max 8 doses per month” to “Maximum 8 doses per month” to keep the formal clinical register.
2. 4.2 — Antihypertensives label shortened: The caution_items entry was restored to the ER’s verbatim bold label, from “Antihypertensives (…)” to “Antihypertensives and other blood-pressure-lowering agents (ACE inhibitors, ARBs, calcium channel blockers, thiazide diuretics)”.

Issues 10/08/2026 02:02

1. 9.5 / 1.3 — Oxymetazoline qualifier dropped: The Key Interactions item at line 592 lists bare “oxymetazoline”, dropping the ER’s scoping qualifier “oral or high-dose nasal” (ER line 339) and thereby extending the caution to ordinary nasal decongestant use.
2. 1.3 — Hypertension threshold hedge removed: The contraindication at line 576 reads “persistently above 140/90 mmHg” where the ER hedges “persistently above roughly 140/90 mmHg” (ER line 353), converting an approximate gate into an exact one.

Fixes 10/08/2026 02:02

1. 9.5 / 1.3 — Oxymetazoline qualifier restored: Changed the Key Interactions decongestant item from “oxymetazoline” to “oral or high-dose nasal oxymetazoline”, restoring the ER’s scoping qualifier so the caution no longer extends to ordinary nasal decongestant use.
2. 1.3 — Hypertension threshold hedge restored: Changed the contraindication from “persistently above 140/90 mmHg” to “persistently above roughly 140/90 mmHg”, matching the ER’s approximate threshold.

Issues 10/08/2026 01:55

1. 2.5 / 2.6 / 2.9 — Imperative in protocol sub-cell: [action_3_sub] (line 484) reads “discontinue after 8 weeks without symptom improvement”, a bare imperative that advises and implicitly addresses the reader; the parallel [time_2_sub] correctly frames the same fact as “The label directs stopping…”.

Fixes 10/08/2026 01:55

1. 2.5 / 2.6 / 2.9 — Imperative removed from protocol cell: [action_3_sub] changed from “discontinue after 8 weeks without symptom improvement” to “use ends after 8 weeks without symptom improvement”, matching the ER’s own declarative phrasing and removing the implied direct address.