Audit: QRS - Recombinant Shingles Vaccine for Health & Longevity

Audit conducted on 24/09/2026 02:11 using AI4L / Opus 5.5

Iterations

Summary

Items	Count
Total	94
Passed	84
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 lede, protocol, time, benefit, risk, gate and monitoring content traced to ER (Conclusion, Therapeutic Protocol, Practical Considerations, Discontinuation, Key Interactions, Monitoring)
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 ER framing kept: “possible but unconfirmed bonus”, “Years, if real”, “unproven”, “(conflicted)”
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 detected; conflicted status of ER headings preserved
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.	🟢	Each fact surfaced under its ER category
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.	🟢	Only ER-present brand names (Zostavax, Arexvy); no PMIDs, NCT IDs or expert names
1.6	The QRS does not introduce new attributions.	🟢

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.	🟢
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢
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 direct address
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms limited to marker/drug names; abbreviations expanded
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.	🟢
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 and time-to-effect note the possible dementia/vascular angle relevant to 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 “anti-aging” wording
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.	🟢	“injection” used throughout; labels follow ER wording

3. Template Integrity

#	Description	Result	Comments
3.1	The following labels and headings on the QRS are fixed and not modified: Card and section headings: “Protocol”, “Time to effect”, “Benefits”, “Risk & Side Effects”, “Monitoring”, “Qualitative Assessment” Gate headings: “Contraindications”, “Key Interactions” Tier labels: “High”, “Medium”, “Low”, “Speculative” Table column headers in Monitoring: “Marker”, “Target”, “Why”	🟢	All fixed labels and headings unchanged
3.2	All “<span data-qrs-var="NAME">...</span>” from the [qrs_template] are present in the the QRS.	🟢	All template spans present (page_title through qualitative_item_#, markers 1-6, qualitative items 1-5)
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	Diff vs template shows only variable content and metadata changed; website spans intact

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 ER source 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 (“Standard schedule”, “Single vs split dosing”, “Immunocompromised schedule”) and interaction labels match 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 characters in file
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.	🟢	Content condensed per section (single-line tier items, trimmed gate parentheticals, short marker rationales)

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 quoted value is duration “00:00”, which contains a colon
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)	🟢	2026-0924-0149
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)	🟢	Opus
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)	🟢	Opus 5.5
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 &)	🟢
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 “a two-dose, non-live injection that protects adults over fifty against shingles”
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	🟢	64 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	🟢
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 6 ER “Populations who should avoid” items present
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.	🟢	Trailing rationales (e.g., “for whom varicella vaccine is indicated instead”) 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).	🟢	Qualifiers kept: fever ≥38.0 °C, 6-week window, defer conditions, absolute contraindication/precaution
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	ER uses 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.	🟢	Section 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. <!-- empty: ER names no population that should avoid the intervention -->	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	🟢	All 10 ER interaction items present; none duplicated from contraindications
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.	🟢
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 and the 8-week interval preserved (shortened where needed)
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	ER uses 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.	🟢	Section 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. <!-- empty: ER names no interaction that changes how the intervention is used -->	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	🟢
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 distinct aspects available
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	🟢	Shingles protection, duration, brain/vascular effect (Practical Considerations, Discontinuation)
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	High-tier shingles protection first, speculative/unproven brain/vascular effect last
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 aspects available
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.	🟢	Only ER heading-level “conflicted” status carried to avoid strengthening (1.3)
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No effect sizes, samples or studies
12.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective <SPAN> 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 populated

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.	🟢	Heading parenthetical “(Fatigue, Muscle Aches, …)” stripped
13.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective <SPAN> 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 populated

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 6 ER 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 5 ER qualitative markers listed

Issues 24/09/2026 02:11

Pass rate 100.00%. No issues found.

Issues 24/09/2026 02:06

1. 1.3 — Optional interval stated as schedule: Line 469 action_3_value “1–2 months apart” turns the ER’s permissive “may shorten the interval to 1–2 months” (ER line 327) into a fixed schedule, strengthening the claim.

Fixes 24/09/2026 02:06

1. 1.3 — Optional interval stated as schedule: Changed action_3_value from “1–2 months apart” to “Interval may shorten to 1–2 months” to match the ER’s permissive wording.

Issues 24/09/2026 02:03

1. 4.5 — Content exceeds one A4 page: Ten Key Interactions items (several wrapping to 2-3 lines in the half-width gate, e.g., line 555), long protocol sub-lines (lines 450-500) and a 5-line lede push the estimated sheet height beyond the printable A4 area; content is not condensed to the one-page budget.
2. 9.4 — Trailing elaborations in interactions: “Other vaccines …: monitor; same-day administration at separate sites” (line 562) and “Prior live zoster vaccine (Zostavax): monitor; interval of at least 8 weeks” (line 564) carry trailing content after the key fact.

Fixes 24/09/2026 02:03

1. 4.5 — Condensed content for one page: Shortened the lede, all protocol and time-to-effect sub-lines, the immunosuppressant interaction (dropped the JAK expansion and example drugs), two monitoring cells and the cadence text to reduce sheet height.
2. 9.4 — Removed trailing interaction elaborations: Dropped “; same-day administration at separate sites” from the Other vaccines item and moved the 8-week interval into the Zostavax parenthetical (“(Zostavax; interval of at least 8 weeks): monitor”).

Issues 24/09/2026 02:01

1. 9.4 — Trailing clauses in interactions: The [caution_items] (lines 555–563) append effect/rationale clauses after the severity class, e.g. “lower efficacy”, “injection-site hematoma”, “preventive use before injection may blunt immune responses to some vaccines” and “combined whole-body reactions may be more noticeable”, instead of just the key fact.

Fixes 24/09/2026 02:01

1. 9.4 — Trailing clauses in interactions: Removed the effect/rationale clauses from the Key Interactions items (e.g., “monitor; lower efficacy” to “monitor”), keeping the severity class plus the same-day separate-site and 8-week interval qualifiers.

Issues 24/09/2026 01:58

1. 2.7 — Unexpanded acronyms IgG and JAK: “IgG” in marker_1_name (line 605) and “JAK inhibitors” in the Immunosuppressants interaction (line 555) are left unexpanded, while other acronyms on the sheet (hs-CRP, MoCA, gE) are expanded; the ER expands both.

Fixes 24/09/2026 01:58

1. 2.7 — Expanded IgG and JAK acronyms: Changed marker_1_name from “Varicella-zoster virus IgG antibody” to “Varicella-zoster virus IgG (immunoglobulin G) antibody” and “JAK inhibitors” to “JAK (Janus kinase) inhibitors” in the Immunosuppressants interaction, using the ER expansions.

Issues 24/09/2026 01:56

1. 2.7 — Unexpanded monitoring marker abbreviations: The Monitoring table names “hs-CRP” (line 627), “MoCA score” (line 638) and “Anti-gE antibody and T-cell response” (line 660) without any plain-language meaning, although the ER defines them (high-sensitivity C-reactive protein, Montreal Cognitive Assessment, glycoprotein E).

Fixes 24/09/2026 01:56

1. 2.7 — Expanded monitoring marker abbreviations: Changed marker names “hs-CRP”, “MoCA score” and “Anti-gE antibody and T-cell response” to “hs-CRP (high-sensitivity C-reactive protein)”, “MoCA (Montreal Cognitive Assessment) score” and “Anti-gE (glycoprotein E) antibody and T-cell response”, using the ER’s own definitions.

Issues 24/09/2026 01:51

1. 1.1 / 1.3 — Varicella test indication broadened: Monitoring marker_1_why (line 611) says “only when chickenpox history is uncertain”, dropping the ER’s restriction to “younger immunocompromised adults” (ER line 382; ER line 204 says testing is unnecessary over 50).
2. 13.3 / 13.4 — Parentheticals retained in risks: risks_high keeps “(fatigue, muscle aches, headache, chills, fever)” after “systemic reactions” and risks_low keeps “(syncope)” after “fainting” (lines 577, 583); parenthetical content should be stripped.

Fixes 24/09/2026 01:51

1. 1.1 / 1.3 — Varicella test indication restored: Changed marker_1_why from “only when chickenpox history is uncertain” to “only when chickenpox history is uncertain in younger immunocompromised adults”, matching the ER.
2. 13.3 / 13.4 — Risk parentheticals stripped: Reduced “systemic reactions (fatigue, muscle aches, headache, chills, fever)” to “systemic reactions” and “fainting (syncope)” to “fainting”.