Audit: QRS - Semaglutide for Health & Longevity

Audit conducted on 05/10/2026 04:20 using AI4L / Opus 5.5

Iterations

Summary

Items	Count
Total	94
Passed	85
Failed	0
N/A	9
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, time-to-effect, benefits, gates, risks, markers and cadence all trace to ER text (Therapeutic Protocol, Practical Considerations, Expected Benefits, Key Interactions & Contraindications, Potential Risks, 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.	🟢	“(theoretical)” retained on all ER-theoretical interactions; speculative risk keeps ER wording.
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”).	🟢
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.	🟢	Contraindications come from “Populations who should avoid”; interactions from the interaction lists; no modifying factors relabelled.
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, NCT IDs, expert or brand names in the QRS.
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	🟢
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical marker names are glossed or unavoidable; contraindications explain MEN 2, gastroparesis and NAION.
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 flags that evidence in lean, healthy adults is nearly absent.
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.	🟢
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.	🟢	Uses “injection” and “tablet” (formal dosage forms); no “shot”/”pill”/”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”	🟢
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_#).
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	Diff against template shows only addressed spans and metadata changed; time_3 hidden per 11.3.

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 used by 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.	🟢	Protocol labels and interaction labels match ER bold labels (parenthetical example lists trimmed per 9.5).
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.	🟢
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 labels/one-liners; nothing extended beyond the template layout.

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 “00:00” is quoted; it 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]”	🟢	26.10.1 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)	🟢
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢
5.9	The nickname of the AI is just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT)	🟢
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢
5.11	The full name of the AI consists of the [qrs_creator_ai_nickname] and the model version number and no additional qualifier (e.g., Opus 4.6, Sonnet 3.2, Grok 4.5, Gemini 3.1, ChatGPT 5.4)	🟢
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢
5.13	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢

6. Page Title & Header

#	Description	Result	Comments
6.1	[page_title] is set to the [canonical_topic] of the ER frontmatter followed by “ - Quick Reference Sheet” (e.g., “Intervention - Quick Reference Sheet”). The [canonical_topic] is HTML-entity-encoded as needed (e.g., & for &)	🟢
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]	🟢	2026-1005-0350 → 10/05/2026.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢
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 “Semaglutide is a prescription medication, given as a weekly injection or daily tablet, used for weight loss and blood-sugar control.”
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	🟢	67 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 six 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.	🟢
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).	🟢	“within 2 months”, “Severe”, “Confirmed … during treatment”, “while using semaglutide tablets” preserved.
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; 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. <!– empty: ER names no population that should avoid the intervention –>	N/A	Section is 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 interactions that change use are listed; “No interaction shown” entries (contraceptives, omeprazole, acetaminophen) omitted.
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 trimmed, never dropped; “(theoretical)” retained.
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; ER names interactions.
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 is 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	ER provides at least three actionable aspects.
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section.	🟢

11. Time to Effect

#	Description	Result	Comments
11.1	The three sets of [time] items cover the three most important time-to-effect aspects from the ER	🟢	ER gives two time-to-effect aspects (weight loss, cardiovascular benefit); both used.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢
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.	🟢	time_3 spans empty and its pcell set to display: none.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢
11.5	If the ER does not provide any information on time to effect, the section is removed completely from the Protocol Panel	N/A	ER provides time-to-effect information.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢
12.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢
12.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective <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 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.	🟢
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	“(muscle)” and “(NAION)” stripped from risk headings.
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 have items.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All 11 table biomarkers plus weight, waist, blood pressure and resting heart rate from the section text.
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 seven ER qualitative markers listed.

Issues 05/10/2026 04:20

Pass rate 100.00%. No issues found.

Issues 05/10/2026 04:17

1. 11.3 — Third time slot misused: The ER gives only two time-to-effect aspects (weight loss over many months; cardiovascular benefit over about 3–4 years), yet QRS lines 505–512 fill the third set with “Reversal of prediabetes / 68 weeks”, which is a trial assessment timepoint, not a time to effect.

Fixes 05/10/2026 04:17

1. 11.3 — Third time slot hidden: Removed the “Reversal of prediabetes / 68 weeks” content from the time_3 spans, left them empty, and hid that cell with style="display: none", because the ER gives only two time-to-effect aspects.

Issues 05/10/2026 04:13

1. 4.5 — Content exceeds one A4 page: The sheet carries 14 Key Interactions items (lines 555-568), 14 Monitoring rows (lines 607-676) and 8 Qualitative items (lines 689-696), which together with the protocol panel and tier lists cannot render on a single A4 page; sections were not condensed to the per-section budget.

Fixes 05/10/2026 04:13

1. 4.5 — Condensed for one A4 page: Trimmed most Key Interactions example lists to one representative example (e.g., “glipizide, glyburide” to “glipizide”, “e.g., furosemide” to “furosemide”), merged the weight/waist and blood-pressure Monitoring rows (14 to 13 rows), removed the “Severe abdominal pain” Qualitative item (not in the ER’s qualitative list; already covered by the lipase row), and shortened “Baseline before starting” to “Baseline” in the cadence.

Issues 05/10/2026 04:09

1. 15.2 — Abdominal pain symptom missing: The ER Monitoring prose (line 533) names “severe abdominal pain” alongside “sudden vision loss” as symptoms prompting urgent assessment, but only vision changes appear in the Qualitative Assessment list (QRS lines 689-695).

Fixes 05/10/2026 04:09

1. 15.2 — Abdominal pain symptom added: Added qualitative_item_8 “Severe abdominal pain” to the Qualitative Assessment list, matching the ER Monitoring prose that pairs it with sudden vision loss as a trigger for urgent assessment.

Issues 05/10/2026 04:08

1. 1.1 — Prediabetes timing misframed: Lines 508–511 present “68 weeks” as the time to effect for “Reversal of prediabetes”, but the ER gives 68 weeks only as the STEP 1 assessment point (“normal blood sugar at 68 weeks”), and the sub does not state it is a measurement point.

Fixes 05/10/2026 04:08

1. 1.1 — Prediabetes timing reframed: Changed time_3_sub from “Most participants with prediabetes reached normal blood sugar while on treatment” to “Assessment point at which most participants with prediabetes had normal blood sugar on treatment”, so 68 weeks reads as the ER’s measurement point rather than a required time to effect.

Issues 05/10/2026 04:02

1. 2.7 — Unexplained jargon in Contraindications: The stop_items use the bare acronym “MEN 2” (line 542) and “Severe gastroparesis” (line 546) without the plain-language glosses the ER provides (“a tumor syndrome”, “stomach paralysis”).
2. 14.2 — Measured vital signs missing: The ER Monitoring section lists body weight, waist circumference, blood pressure and resting heart rate as baseline and ongoing measurements, but the biomarker table (lines 607-661) omits all four.

Fixes 05/10/2026 04:02

1. 2.7 — Glossed Contraindications jargon: Added the ER’s plain-language glosses: “medullary thyroid carcinoma (a rare thyroid cancer) or MEN 2 (an inherited tumor syndrome)” and “Severe gastroparesis (stomach paralysis)”.
2. 14.2 — Added missing measured markers: Added three Monitoring rows from the ER Monitoring section: “Body weight and waist circumference” and “Blood pressure” (expected change: falls), and “Resting heart rate” (safety check: sustained rise), each tracked against own baseline.

Issues 05/10/2026 03:59

1. 4.5 — Sheet exceeds one A4 page: The Key Interactions gate (lines 555–568) holds 14 items with untrimmed example lists such as “(warfarin, digoxin, atorvastatin, metformin)” and “(berberine, cinnamon, chromium, alpha-lipoic acid)”, which together with the 11-row Monitoring table and the long tablet sub-line (line 461) push the sheet well past one A4 page.

Fixes 05/10/2026 03:59

1. 4.5 — Condensed for one-page budget: Trimmed the parenthetical example lists in four Key Interactions items (e.g., “(warfarin, digoxin, atorvastatin, metformin)” to “(warfarin, digoxin)”, “(berberine, cinnamon, chromium, alpha-lipoic acid)” to “(berberine, chromium)”, dropped the redundant “tirzepatide” and “glimepiride” examples) and shortened the daily-tablet sub-line; every item still keeps at least one example.

Issues 05/10/2026 03:56

1. 4.2 / 4.3 — Protocol labels truncated: action_1_label and action_2_label (QRS lines 444, 455) read “Standard weekly injection” and “Daily tablet”, dropping the “(weight and cardiovascular use)” qualifier from the ER bold labels at ER lines 471–472.

Fixes 05/10/2026 03:56

1. 4.2 / 4.3 — Protocol labels restored verbatim: Changed action_1_label from “Standard weekly injection” to “Standard weekly injection (weight and cardiovascular use)” and action_2_label from “Daily tablet” to “Daily tablet (weight and cardiovascular use)”, matching the ER bold labels.

Issues 05/10/2026 03:53

1. 2.7 — Unexplained NAION acronym: The Contraindications item “Confirmed NAION during treatment” (QRS line 547) uses an acronym a non-specialist cannot decode, while the ER’s plain term “optic nerve stroke” is used for the same condition in the Risks card (line 584).

Fixes 05/10/2026 03:53

1. 2.7 — Unexplained NAION acronym: Changed the Contraindications item from “Confirmed NAION during treatment” to “Confirmed optic nerve stroke (NAION) during treatment”, using the ER’s own plain term already shown in the Risks card.