Audit: QRS - Simvastatin to Lower LDL

Audit conducted on 30/07/2026 02:30 using AI4L / Opus 4.8

Iterations

Summary

Items Count
Total 91
Passed 83
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 protocol, benefit, risk, gate, and monitoring content traces to the ER.
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. 🟢 No cautious ER phrasing was strengthened or softened.
1.3 The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”). 🟢 Contraindications (pregnancy, breastfeeding) preserved at full 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. 🟢 Interactions/contraindications sourced from the ER’s own Key Interactions & Contraindications section.
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. 🟢 QRS contains no citations, PMIDs, NCT IDs, or expert names.
1.6 The QRS does not introduce new attributions. 🟢 No attributions present.

2. Focus, Tone & Audience

# Description Result Comments
2.1 The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing. 🟢 Objective, evidence-forward tone consistent with the ER.
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 🟢 Presents evidence, not directives.
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 are paired with plain-language cues.
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. 🟢 Framing reflects risk-aware, prevention-minded readers.
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. 🟢 At-a-glance notes benefit is smaller at lower risk, matching ER framing.
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” language present.
2.15 The document’s own voice uses formal clinical and scientific terminology, not colloquial or consumer-grade language (e.g., “oral medication” not “pill(s)”; “injection” not “shot”; “adverse event” not “bad reaction”). Direct quotes from sources are exempt. 🟢 Uses “medication”, “muscle symptoms”; no consumer-grade terms.

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 and labels are intact.
3.2 All “” from the [qrs_template] are present in the the QRS. 🟢 All template spans present (markers 1–9, qualitative 1–5 expanded).
3.3 Spans that are not addressed in a checklist item are left unchanged 🟢  

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 drawn on 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. 🟢 Monitoring marker names carried verbatim from the ER table.
4.3 Labels are not paraphrased, abbreviated, or invented. 🟢 Marker and tier labels match the ER.
4.4 The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. 🟢 No emoji indicators in the rendered content.
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 to fit a single sheet.

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. 🟢 Comment block at lines 2–14, immediately after doctype.
5.2 Inside that HTML comment the YAML block is delimited by a line “—” opening and a line “—” closing. Text before the opening “—” is permitted but is not parsed as YAML. 🟢 YAML delimited at lines 3 and 13.
5.3 The metadata is not visible in any rendered view of the QRS and is not surfaced by any other element on the sheet. 🟢 Enclosed in an HTML comment.
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. 🟢 duration quoted (contains colon); others unquoted.
5.5 The filename of the source ER is stated as “er_filename: [er_filename]” 🟢 er_filename: simvastatin_ldl_2026-0730-0123_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: 26.7.02
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: 2026-0730-0224
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) 🟢  
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 4.8
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]” 🟢 qrs_filename: simvastatin_ldl_2026-0730-0123_Opus_QRS.html
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., &amp; for &) 🟢 “Simvastatin to Lower LDL - 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 &) 🟢 “Simvastatin to Lower LDL”
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢 07/30/2026
6.4 [header_subline_model] is set to [qrs_creator_ai_fullname] 🟢 Opus 4.8
6.5 No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker. 🟢 Header carries only the standard subline.

7. At-A-Glance Section

# Description Result Comments
7.1 [at_a_glance] is dense, execution-oriented summary of the ER Conclusion section 🟢 Condenses the Conclusion faithfully.
7.2 [at_a_glance] is no longer than 60 words 🟢 58 words.
7.3 Every fact in [at_a_glance] is supported by a distinct passage in the ER. 🟢 Each clause maps to the Conclusion.
7.4 It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead 🟢 LDL paired with plain “bad” cholesterol; no unexplained jargon.
7.5 It DOES NOT cite specific trials (names, years, sample sizes, p-values) 🟢 No trials cited.
7.6 It DOES NOT cite effect sizes, relative risks, or statistical results 🟢 No statistics.

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 🟢 Strong CYP3A4 inhibitors, gemfibrozil/cyclosporine/danazol, pregnancy/breastfeeding, active liver disease, 80 mg dose.
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. 🟢 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). 🟢 Threshold “> ~3× upper normal limit” 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. 🟢 Inhibitor examples given as a comma list.
8.7 If no [stop_items] are present the section is left empty N/A Contraindications are present.

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 🟢 Moderate inhibitors, niacin, grapefruit, red yeast rice, St. John’s wort, alcohol, exercise.
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. 🟢 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 drugs and 10–20 mg dose cap preserved.
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. 🟢 Comma-separated drug lists.
9.7 If no [caution_items] are present the section is left empty N/A Key interactions are present.

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 🟢 Starting dose, timing, ezetimibe combination.
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 actionable aspects are present.
10.4 All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section. 🟢 All three cells populated from the 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 🟢 LDL starts falling, full effect, recheck lipids.
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢 All tied to the primary LDL-lowering benefit, ordered chronologically.
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 time-to-effect aspects are present.
11.4 All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER. 🟢 All three sets populated from the ER Practical Considerations.
11.5 If the ER does not provide any information on time to effect, the section is removed completely from the Protocol Panel N/A The ER provides time-to-effect information.

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] 🟢 All four tiers 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. 🟢 Bare tier facts only.
12.4 Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 No parentheticals carried through.
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 sub-sections contain 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] 🟢 All four tiers 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. 🟢 Bare tier facts only.
13.4 Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 “(Myalgia)” and frequencies stripped.
13.5 If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing. N/A All four sub-sections contain 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 9 ER biomarkers present with targets and rationale.
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 text matches the ER monitoring protocol.

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 qualitative markers present.

Issues 30/07/2026 02:30

Pass rate 100.00%. No issues found.