Audit: QRS - Silymarin for Health & Longevity
Audit conducted on 25/09/2026 04:49 using AI4L / Opus 5.5
Summary
| Items | Count |
|---|---|
| Total | 94 |
| Passed | 86 |
| Failed | 0 |
| N/A | 8 |
| 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. | 🟢 | All QRS content traced to ER: At-a-Glance to Conclusion (ER l.437-441), gates to Key Interactions & Contraindications (l.304-322), protocol to Therapeutic Protocol (l.340-342), time to effect to Practical Considerations (l.376), tiers to Expected Benefits / Potential Risks headings, monitoring to table and cadence (l.393-421). |
| 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 framing kept: “It appears to reduce some drug-caused liver injury”, “blood-fat effects are less certain”, “Benefit is uncertain” mirror ER Conclusion; theoretical estrogen and contamination concerns sit in Speculative tier. |
| 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 found; “Populations who should avoid” items kept as Contraindications with their original conditions (e.g., “unless extra INR monitoring is arranged”). |
| 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 ER “Populations who should avoid”; interactions from ER interaction bullets; risk/benefit items from their own ER sections; no modifying factor relabeled. |
| 1.5 | PubMed IDs, study citations, expert names, clinical trial identifiers (NCT*), and brand names appear in the QRS only if they appear in the source ER for the same fact. | 🟢 | No PMIDs, citations, expert names, NCT IDs or brand names appear in the QRS. |
| 1.6 | The QRS does not introduce new attributions. | 🟢 | No attributions introduced. |
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, evidence-weighted tone of the ER Conclusion carried over. |
| 2.2 | The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging | 🟢 | Expert and data-driven yet accessible. |
| 2.3 | The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor | 🟢 | Presents findings without prescriptive instructions. |
| 2.4 | The QRS avoids language that implies medical or clinical advice | 🟢 | No clinical-advice language beyond the fixed template disclaimer. |
| 2.5 | The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” | 🟢 | Content presents information; no “recommend”/”advise” phrasing. |
| 2.6 | The QRS never addresses “the reader” directly — it presents evidence, not guidance | 🟢 | No direct reader address. |
| 2.7 | The QRS is written in plain language, avoiding unnecessary medical jargon | 🟢 | Plain language used; remaining technical terms (e.g., “CYP2C9-processed drugs”, “NSAID class”) are the ER’s own gate labels required verbatim by 4.2. |
| 2.8 | Information is presented in a concise and very compact manner | 🟢 | Compact phrasing throughout. |
| 2.9 | It DOES NOT address the reader directly | 🟢 | No “you”/reader address found. |
| 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. | 🟢 | Framing fits proactive, health-oriented adults (e.g., optimal-marker caveat, extensive biomarker panel). |
| 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. | 🟢 | Multi-dose regimens and detailed monitoring presented without hedging on 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. | 🟢 | Not framed for the general population. |
| 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 notes “Benefit is uncertain when liver and metabolic markers are already optimal”, reflecting this audience’s signal (ER l.441). |
| 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. | 🟢 | No colloquial route or adverse-event terms; “blood thinner” in the lede is the plain-language descriptor required by 7.5 and matches ER Conclusion 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 headings, gate headings, tier labels and column headers unchanged (QRS l.440, 477, 519, 539, 551, 572, 591, 595-597, 776). |
| 3.2 | All “…” from the [qrs_template] are present in the the QRS. | 🟢 | All template spans present; marker_# and qualitative_item_# expanded to numbered instances (script diff of span names). |
| 3.3 | Spans that are not addressed in a checklist item are left unchanged | 🟢 | Head/CSS block identical to template (diff); static markup unchanged; only addressed spans modified (risks_high/medium hidden per 13.5). |
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” | 🟢 | No QRS section maps to an empty ER section requiring empty-state text; empty risk tiers are hidden per 13.5. |
| 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. | 🟢 | ER bold labels used verbatim: protocol labels (QRS l.444, 455, 466), interaction labels (l.554-562), biomarker names (l.603-757). |
| 4.3 | Labels are not paraphrased, abbreviated, or invented. | 🟢 | Labels match ER; time labels (Blood sugar, Liver enzymes, Liver stiffness) are taken from ER l.376 wording. |
| 4.4 | The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. | 🟢 | No emoji indicators. |
| 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 from the ER (e.g., parentheticals, severity notes and mitigations stripped); remaining length is driven by mandated completeness (14.2 all biomarkers, 9.5 qualifiers). |
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. | 🟢 | Metadata comment immediately follows <!doctype html> (QRS l.2-14). |
| 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. | 🟢 | YAML delimited by “—” lines (l.3, l.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. | 🟢 | Inside HTML comment; not rendered. |
| 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. | 🟢 | Values trimmed; only duration “00:01” quoted (contains colon). |
| 5.5 | The filename of the source ER is stated as “er_filename: [er_filename]” | 🟢 | er_filename: silymarin_2026-0925-0306_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: 26.9.25 matches QRS.md version. |
| 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: 2026-0925-0440 |
| 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” is a single word. |
| 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 [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” = nickname + version. |
| 5.12 | The filename of the document is stated as “qrs_filename: [filename of this document]” | 🟢 | qrs_filename matches the file name. |
| 5.13 | All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting. | 🟢 | All values clean and consistent. |
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 &) |
🟢 | “Silymarin for Health & Longevity - Quick Reference Sheet” (l.22). |
| 6.2 | [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &) |
🟢 | “Silymarin for Health & Longevity” (l.417). |
| 6.3 | [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] | 🟢 | 09/25/2026 matches 2026-0925-0440. |
| 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. | 🟢 | No extra header content. |
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 “Silymarin, an inexpensive supplement from milk thistle seeds long used for liver health”. |
| 7.2 | [at_a_glance] is dense, execution-oriented summary of the ER Conclusion section |
🟢 | Condenses ER Conclusion: main benefit, drug-induced liver injury, lipid uncertainty, optimal-marker caveat, safety and warfarin interaction. |
| 7.3 | [at_a_glance] is no longer than 70 words | 🟢 | 70 words (script count). |
| 7.4 | Every fact in [at_a_glance] is supported by a distinct passage in the ER. | 🟢 | Each fact maps to ER Conclusion l.437 and l.441. |
| 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) | 🟢 | No trials cited. |
| 7.7 | It DOES NOT cite effect sizes, relative risks, or statistical results | 🟢 | No effect sizes or statistics. |
8. Contraindications
| # | Description | Result | Comments |
|---|---|---|---|
| 8.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | From ER Key Interactions & Contraindications (l.316-322). |
| 8.2 | [stop_items] represent the Contraindications from the ER | 🟢 | All five ER “Populations who should avoid” items present (l.542-546). |
| 8.3 | Individual [stop_items] are formatted as <li></li> | 🟢 | Each item in <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. | 🟢 | Concise; rationale “(insufficient safety data)” and explanatory glosses removed; no trailing dash clauses. |
| 8.5 | Parenthetical qualifiers from the ER bullet — time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely). | 🟢 | Qualifiers kept: plant list, cancer/condition list, “Child-Pugh Class B or C”, “in the past 3 months”. |
| 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 in contraindications. |
| 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 is not empty. |
9. Key Interactions
| # | Description | Result | Comments |
|---|---|---|---|
| 9.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | From ER Key Interactions & Contraindications (l.304-314). |
| 9.2 | [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications | 🟢 | All ER interactions that change use are listed; CYP3A4 (“no clinically meaningful change”) and acetaminophen (“No harmful interaction known”) correctly omitted. |
| 9.3 | Individual [caution_items] are formatted as <li></li> | 🟢 | Each item in <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. | 🟢 | Severity words, mechanisms and mitigations stripped; no trailing dash clauses. |
| 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/supplement lists and the “in hormone-sensitive conditions” qualifier kept. |
| 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 in interactions. |
| 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 relevant 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. | N/A | Section is not empty. |
10. Protocol
| # | Description | Result | Comments |
|---|---|---|---|
| 10.1 | The section is derived from the ER Protocol section |
🟢 | From ER Therapeutic Protocol (l.340-342). |
| 10.2 | The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section |
🟢 | Three core dosing regimens (European, metabolic, phytosome) cover the main actionable aspects. |
| 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 exist. |
| 10.4 | All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section. |
🟢 | All label/value/sub fields filled from ER. |
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 | 🟢 | Covers the three ER time-to-effect aspects (l.376). |
| 11.2 | The sets are picked and ordered by the magnitude of the related benefit | 🟢 | Blood sugar (High benefit) first, then liver enzymes and liver stiffness (Low-tier liver benefits). |
| 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 exist. |
| 11.4 | All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER. | 🟢 | All fields filled from ER l.376. |
| 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 data. |
12. Benefits
| # | Description | Result | Comments |
|---|---|---|---|
| 12.1 | The section is derived from the ER Expected Benefits section |
🟢 | From ER Expected Benefits (l.151-225). |
| 12.2 | Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] | 🟢 | All four variables populated. |
| 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. | 🟢 | ER headings only; no qualifiers or effect sizes. |
| 12.4 | Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | No parentheticals. |
| 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 benefit tiers have items. |
13. Risks
| # | Description | Result | Comments |
|---|---|---|---|
| 13.1 | The section is derived from the ER Potential Risks & Side Effects section |
🟢 | From ER Potential Risks & Side Effects (l.238-290). |
| 13.2 | Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] | 🟢 | Variables present; Low and Speculative populated. |
| 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. | 🟢 | ER headings only; no frequencies or explanations. |
| 13.4 | Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | No parentheticals. |
| 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. | 🟢 | risks_high and risks_medium set to display: none (l.574, 577); ER states no risk reaches these tiers. |
14. Monitoring
| # | Description | Result | Comments |
|---|---|---|---|
| 14.1 | The section is derived from the ER Monitoring section |
🟢 | From ER Monitoring Protocol & Defining Success (l.391-413). |
| 14.2 | All measurable/quantifiable biomarkers from the Monitoring section are listed |
🟢 | All 15 ER biomarkers listed with matching targets. |
| 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. |
🟢 | Cadence reflects ER l.395. |
15. Qualitative Assessment
| # | Description | Result | Comments |
|---|---|---|---|
| 15.1 | The section is derived from the ER Monitoring section |
🟢 | From ER Monitoring section (l.415-421). |
| 15.2 | All subjective/qualitative biomarkers from the Monitoring section are listed |
🟢 | All 5 qualitative markers listed verbatim. |
Issues 25/09/2026 04:49
Pass rate 100.00%. No issues found.
Issues 25/09/2026 04:47
- 1.3 — Usual-dose qualifier dropped: At a Glance (QRS line 433) says “Side effects are mostly mild digestive upset” without the ER Conclusion’s “At usual doses” (ER line 441), broadening the safety claim despite documented high-dose bilirubin/ALT rises.
- 4.2 / 4.3 — NSAID label abbreviated: Key Interactions item “NSAID analgesics (ibuprofen, naproxen)” (QRS line 557) paraphrases and abbreviates the ER bold label “Over-the-counter analgesics of the NSAID class” (ER line 308).
Fixes 25/09/2026 04:47
- 1.3 — Usual-dose qualifier restored: Changed “Side effects are mostly mild digestive upset” to “At usual doses, side effects are mostly mild digestive upset” in At a Glance, trimming two words elsewhere to stay within 70 words.
- 4.2 / 4.3 — NSAID label made verbatim: Replaced “NSAID analgesics (ibuprofen, naproxen)” with the ER label “Over-the-counter analgesics of the NSAID class (ibuprofen, naproxen)” in Key Interactions.
Issues 25/09/2026 04:41
- 2.13 — Lede omits audience caveat: The at-a-glance (line 433) drops the ER Conclusion’s audience-specific point that measurable benefit is uncertain for people whose liver and metabolic markers are already in optimal ranges (ER line 441).
- 8.4 — Rationale parenthetical in contraindication: “Pregnancy and breastfeeding (insufficient safety data)” (line 543) carries an explanatory rationale rather than an applicability qualifier; the parenthetical should be stripped.
Fixes 25/09/2026 04:41
- 2.13 — Added audience caveat to lede: Reworded the at-a-glance (now 69 words) to add the ER Conclusion’s point that benefit is uncertain when liver and metabolic markers are already optimal.
- 8.4 — Stripped rationale parenthetical: Changed “Pregnancy and breastfeeding (insufficient safety data)” to “Pregnancy and breastfeeding”.