Audit: QRS - PT-141 for Health & Longevity

Audit conducted on 10/30/2026 13:56 using AI4L / Opus 5.5

Iterations

Summary

Items Count
Total 97
Passed 85
Failed 0
N/A 12
Pass Rate 100.00%
  • Total = Passed + Failed + N/A
  • Pass Rate = Passed / (Passed + Failed) × 100
  • N/A items are excluded from the pass rate calculation

1. General Rules

# Description Result Comments
1.1 Every claim, magnitude, label, recommendation, and statement in the QRS is literally supported by content in the source ER. 🟢 Lede, Protocol, Time to effect, gates, tiers, markers and cadence each trace to ER text (Conclusion, Therapeutic Protocol, Practical Considerations, Key Interactions & Contraindications, Monitoring Protocol).
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 phrasing kept where carried: “Split dosing is unstudied”, “no regimen is approved for men”, “not on-demand use”, “No established target”.
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 claim strengthened or softened; contraindications and stopping rule kept at ER strength.
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. 🟢 Facts kept in their ER categories (documented vs theoretical interactions, populations to avoid, 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, trial names, NCT IDs, experts or brand names; drug names (sildenafil, tirzepatide, amoxicillin etc.) are in the ER for the same facts.

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. 🟢 Matches the ER’s measured, evidence-weighing tone.
2.2 The tone of the QRS is expert, accessible, objective, and data-driven 🟢  
2.3 The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor 🟢  
2.4 The QRS avoids language that implies medical or clinical advice 🟢  
2.5 The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” 🟢  
2.6 The QRS never addresses the reader directly — it presents evidence, not guidance 🟢 No second-person address.
2.7 The QRS is written in plain language, avoiding unnecessary medical jargon 🟢 Technical terms (HSDD, eGFR, Child-Pugh C, FSFI, FSDS-DAO) appear only inside verbatim ER labels/marker names.
2.8 Information is presented in a concise and very compact manner 🟢  
2.9 The target audience is health- and longevity-oriented adults who are risk-aware, proactive, and actively seeking to optimize health or apply the intervention under review. 🟢  
2.10 The target audience is willing to employ lifestyle and behavioral changes as well as follow protocols that may be inconvenient, costly, or require effort. 🟢  
2.11 The document is NOT written for the general population, who are unwilling to employ lifestyle and behavioral changes or follow protocols that may be inconvenient, costly, or require effort. 🟢  
2.12 Framing, takeaways, and risk/benefit weighting throughout the document reflect this audience, including where an intervention’s signal for the average person differs from its signal for this audience. 🟢 Lede addresses off-label use by men, postmenopausal women and weight control, the relevant use cases for this audience.
2.13 The document’s own voice frames usage in longevity terms, not “anti-aging” (e.g., “anti-aging clinics”, “anti-aging community”, “anti-aging medicine”). Proper names that contain “anti-aging” (e.g., “American Academy of Anti-Aging Medicine”) are quoted verbatim. 🟢 No “anti-aging” wording.
2.14 The document’s own voice uses formal clinical and scientific terminology, not colloquial or consumer-grade language (e.g., “oral medication” not “pill(s)”; “oral” / “administered orally” not “taken by mouth” / “given by mouth”; “injection” not “shot”; “adverse event” not “bad reaction”). This holds on EVERY surface, including the QRS lede — the stricter plain-language bar (see 2.7) does not license lay phrasing for route of administration. Direct quotes from sources are exempt. 🟢 Formal terms used (subcutaneous injection, oral drugs, autoinjector).

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, tier labels and column headers as in template.
3.2 Every element carrying a data-qrs-var attribute in [qrs_template] is present in the QRS with the same name 🟢 All template data-qrs-var names present; marker_# expanded to 1–10, qualitative_item_# to 1–6.
3.3 Everything outside the data-qrs-var spans — markup, text, styles, comments — is as in the template; spans that no checklist item addresses are left unchanged as well 🟢 Diff vs template shows changes only inside data-qrs-var spans, expanded rows/items and metadata values (plus workflow fields duration/git_user/git_issue).

4. Formatting

# Description Result Comments
4.1 An empty ER section never produces visible empty-state text in the QRS: the corresponding region is hidden or left empty. Phrases such as “None documented in human trials to date” or “Not formally studied” appear only where the ER uses them for a fact the QRS carries over. 🟢 No empty-state text; “Not specified in the ER” (marker_10) is the wording 14.3 requires.
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 “Label regimen (premenopausal women with HSDD)”, “Single versus split dosing”, “Male research doses” and gate labels are ER bold labels verbatim.
4.3 Labels are not paraphrased, abbreviated, or invented. 🟢 Example lists trimmed with ER words kept (e.g., “Antihypertensives (amlodipine, lisinopril)”); no invented labels.
4.4 The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. 🟢 No emoji in the QRS.
4.5 The QRS is designed to render on one A4 page. It fails this item only for one of four things: a trailing clause after a dash, an optional gloss, an example list left untrimmed, or a repetition. Nothing else is cut to fit. 🟢 No trailing dash clauses, untrimmed example lists, optional glosses or repetitions found.

5. Metadata

# Description Result Comments
5.1 The metadata is placed inside a single HTML comment that is the first element after “<!doctype html>” and before any other comment, head, or body content. 🟢  
5.2 Inside that HTML comment the YAML block is delimited by a line “—” opening and a line “—” closing. Text before the opening “—” is permitted but is not parsed as YAML. 🟢  
5.3 The metadata is not visible in any rendered view of the QRS and is not surfaced by any other element on the sheet. 🟢  
5.4 All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting. 🟢 Only duration “00:02” is quoted (contains colon).
5.5 The filename of the source ER is stated as “er_filename: [er_filename]” 🟢 er_filename: pt_141_2026-1030-1040_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]” 🟢 qrs_prompt_version: 26.10.25
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: 2026-1030-1336
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 the full name without the version number, with all remaining words joined by hyphens (e.g., Opus, Sonnet, Grok, Gemini-Flash, GPT); when the full name has no version number or is “Unknown”, the nickname equals the full name 🟢  
5.10 The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]” 🟢 qrs_creator_ai_fullname: Opus 5.5
5.11 The full name of the AI consists of the model name (the word or words directly before the version number, leaving out the first if there is more than one, e.g., Claude Opus 5.5 → Opus 5.5), the model version number and the variant (if any) as stated in the system prompt or developer instructions of the creating model, with every word capitalized and without product, effort or pricing names (e.g., Opus X.Y, Sonnet X.Y, Grok X.Y, Gemini X.Y Flash, GPT X.Y), the model name alone when the system prompt or developer instructions name a model without a version number (e.g., Grok), or “Unknown” when neither the system prompt nor the developer instructions of the creating model name a model 🟢  
5.12 The filename of the document is stated as “qrs_filename: [filename of this document]” 🟢 qrs_filename: pt_141_2026-1030-1040_Opus_QRS.html

6. Page Title & Header

# Description Result Comments
6.1 [page_title] is set to the [canonical_topic] of the ER frontmatter followed by “ - Quick Reference Sheet” (e.g., “Intervention - Quick Reference Sheet”). The [canonical_topic] is HTML-entity-encoded as needed (e.g., &amp; for &) 🟢 “PT-141 for Health & Longevity - Quick Reference Sheet”
6.2 [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., &amp; for &) 🟢  
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢 10/30/2026
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 “a lab-made injectable prescription medication” and its approved use before any verdict.
7.2 [at_a_glance] is dense, execution-oriented summary of the ER Conclusion section 🟢 Condenses the ER Conclusion’s three paragraphs.
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. 🟢  
7.5 It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead 🟢 No acronyms or specialist terms.
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 PT-141” items listed.
8.3 Individual [stop_items] are formatted as <li></li> 🟢  
8.4 Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact. 🟢 Rationale after each ER colon 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). 🟢 eGFR <30 and Child-Pugh C thresholds kept; “(e.g., sickle cell disease)” 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. N/A No ranking notation in ER contraindication items.
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 ER’s documented interactions — the items under its “Documented interactions:” label — excluding any that are already listed as Contraindications and any entry phrased as no interaction found 🟢 Naltrexone excluded (already a contraindication); ondansetron excluded (no effect found).
9.3 [caution_theoretical_items] represent the ER’s theoretical interactions — the items under its “Theoretical interactions (inferred from mechanism, not studied in humans):” label 🟢 All 7 ER theoretical interactions listed.
9.4 The ER placeholder “None identified” is never an item: it means that group is empty 🟢  
9.5 Individual [caution_items] and [caution_theoretical_items] are formatted as <li></li>. The template’s bold “Theoretical (inferred from mechanism)” sub-heading is the only marker of the second list’s status: no item carries “(theoretical)”, “inferred from” or a mechanism clause 🟢 No item carries “(theoretical)”, “inferred from” or a mechanism clause.
9.6 Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact. 🟢  
9.7 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 kept (trimmed, at least one example each).
9.8 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 No ranking notation in ER interaction items.
9.9 If the ER’s theoretical group is empty, the whole Theoretical block — the caution_theoretical span with its sub-heading and list — is hidden with style="display:none", not removed: its spans stay in place, empty. N/A ER theoretical group is not empty.
9.10 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. 🟢 Section populated.
9.11 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, and the Theoretical block is hidden per 9.9. E.g. N/A Section not empty.

10. Protocol

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

11. Time to Effect

# Description Result Comments
11.1 The three sets of [time] items cover the three most important time-to-effect aspects from the ER 🟢 Peak level/onset for desire, 8-week judgment of benefit, 16-day weight effect (ER Practical Considerations, Therapeutic Protocol, Expected Benefits).
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢 High-tier desire benefit first, Medium-tier weight last.
11.3 If fewer than three distinct time-to-effect aspects are mentioned in the ER, the unused sets are left empty and hidden with style="display:none", not filled with placeholder text or empty-state phrasing. N/A ER gives at least three time-to-effect aspects.
11.4 All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER. 🟢  
11.5 If the ER provides no information on time to effect at all, the whole Time to effect block (its subhead and all three sets) is hidden with style="display:none", not removed: its spans stay in place, empty. N/A ER provides time-to-effect information.

12. Benefits

# Description Result Comments
12.1 The section is derived from the ER Expected Benefits section 🟢  
12.2 Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] 🟢  
12.3 Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact. 🟢 Items are the ER benefit headings without magnitudes or the Conflicted marker.
12.4 Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢  
12.5 If a tier (high, medium, low, speculative) has no items, its span is hidden with style="display:none", not filled with “None documented in human trials to date” or similar empty-state phrasing. N/A All four tiers have items.

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. 🟢 Items are the ER risk headings without frequencies.
13.4 Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢  
13.5 If a tier (high, medium, low, speculative) has no items, its span is hidden with style="display:none", not filled with “None documented in human trials to date” or similar empty-state phrasing. N/A All four tiers have items.

14. Monitoring

# Description Result Comments
14.1 The section is derived from the ER Monitoring Protocol & Defining Success section 🟢  
14.2 All measurable/quantifiable biomarkers from that section are listed, one table row per marker; the template’s # row is the pattern, repeated with # replaced by 1, 2, 3 … in the data-qrs-var names 🟢 All 8 table biomarkers plus FSDS-DAO item 13 and bilirubin named in the section’s notes.
14.3 [marker_#name] is the marker, [marker#target] its target value or range as given in the ER, [marker#_why] its purpose in a few words; a target the ER does not give is written “Not specified in the ER” 🟢 Targets match the ER’s Optimal Functional Range column; bilirubin written “Not specified in the ER”.
14.4 [monitoring_cadence] is populated with the monitoring cadence/frequency derived from that section. It is not left with placeholder text or empty. 🟢 Cadence matches the ER’s ongoing-monitoring paragraph.
14.5 If the ER names no measurable biomarker, the table is hidden with style="display:none" and the single # row is left as in the template N/A ER names measurable biomarkers.

15. Qualitative Assessment

# Description Result Comments
15.1 The section is derived from the ER Monitoring Protocol & Defining Success section 🟢  
15.2 All subjective/qualitative markers from that section are listed, one <li> per marker; the template’s # item is the pattern, repeated with # replaced by 1, 2, 3 … 🟢 All 6 ER qualitative markers listed.
15.3 If the ER names no qualitative marker, the card’s list is hidden with style="display:none" and the single # item is left as in the template N/A ER names qualitative markers.

Issues 10/30/2026 13:56

Pass rate 100.00%. No issues found.

Issues 10/30/2026 13:50

  1. 4.3 — Invented Time to effect label: time_1_label at QRS line 489 reads “Per-dose timing”, a label not found in the ER; the related ER benefit heading is “Sexual Desire and Desire-Related Distress in Premenopausal Women with HSDD”.

Fixes 10/30/2026 13:50

  1. 4.3 — Invented Time to effect label: Replaced time_1_label “Per-dose timing” with the ER benefit heading “Sexual desire and desire-related distress in premenopausal women with HSDD”.

Issues 10/30/2026 13:46

  1. 14.2 — Two monitoring markers missing: The Monitoring table (lines 622-711) lists the 8 ER table rows but omits the FSDS-DAO item 13 distress score (“pair with FSDS-DAO item 13 (responder threshold: a decrease of at least 1 point) for distress”) and bilirubin (“pair with bilirubin”), both measurable markers in the ER Monitoring section.

Fixes 10/30/2026 13:46

  1. 14.2 — Two monitoring markers added: Added Monitoring rows marker_9 (FSDS-DAO item 13 distress score, target “Decrease of at least 1 point (responder threshold)”) and marker_10 (Bilirubin, target “Not specified in the ER”), both taken from the ER Monitoring section.

Issues 10/30/2026 13:44

  1. 1.1 — Liver test cadence altered: The cadence at line 715 says “liver tests only if symptoms such as jaundice or dark urine appear”, while the ER says liver tests are “repeated only if symptoms” after a baseline that includes liver function.
  2. 4.5 — 45-minute timing repeated: “at least 45 minutes before anticipated sexual activity” in action_1_sub (line 456) is repeated as “≥45 minutes before sexual activity” in time_1_value (line 492).

Fixes 10/30/2026 13:44

  1. 1.1 — Liver test cadence altered: Changed “liver tests only if symptoms” to “liver tests repeated only if symptoms” in monitoring_cadence to match the ER.
  2. 4.5 — 45-minute timing repeated: Replaced time_1_value “≥45 minutes before sexual activity” with “About 1 hour to peak plasma levels” and trimmed time_1_sub to “Desire rose for up to 24 hours in one trial”.

Issues 10/30/2026 13:39

  1. 1.1 — Unsupported onset claim: Time to effect cell 1 (QRS lines 489-495) reads “Per-dose onset” / “≥45 minutes”, stating that onset takes at least 45 minutes, whereas the ER only says “dosing is at least 45 minutes before sexual activity”.
  2. 4.5 — Repetition in time cell: Time to effect cell 2 (QRS lines 500-506) repeats its label and value in the sub “Benefit is judged over 8 weeks; …”.

Fixes 10/30/2026 13:39

  1. 1.1 — Unsupported onset claim: Changed Time to effect cell 1 from “Per-dose onset” / “≥45 minutes” to “Per-dose timing” / “≥45 minutes before sexual activity”, matching the ER’s dosing-timing wording.
  2. 4.5 — Repetition in time cell: Removed “Benefit is judged over 8 weeks;” from time_2_sub, leaving “The label calls for discontinuation if symptoms have not improved”.