Audit: QRS - Simvastatin to Lower LDL
Audit conducted on 24/09/2026 02:46 using AI4L / Opus 5.5
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
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. | 🟢 | Spot-checked every span (lede, protocol, time, tiers, gates, markers, cadence) against ER lines 129-401; all supported |
| 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, e.g. “possibly dampened fitness gains” (ER line 419) |
| 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/softening; “(avoid)” and dose caps mirror ER lines 289-295 |
| 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. | 🟢 | Gates drawn from ER Key Interactions & Contraindications; tiers from Expected Benefits / Potential Risks |
| 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, NCT IDs, study names or brand names introduced |
| 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 decision-gate precision (CYP3A4, rs4149056) carried from ER |
| 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 notes larger gains in higher-risk people (ER line 417) |
| 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. | 🟢 | “oral medication”, “adverse events” used |
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 identical to template |
| 3.2 | All “…” from the [qrs_template] are present in the the QRS. | 🟢 | Span set matches template (marker_# expanded 1-12, qualitative_item_# expanded 1-5) |
| 3.3 | Spans that are not addressed in a checklist item are left unchanged | 🟢 | Head/CSS identical to template apart from page_title; website spans 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 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 dose range”, “Intensity positioning”, “Single or split dose” and qualitative labels verbatim from ER |
| 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 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. | 🟢 | Sections condensed to key facts |
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. | 🟢 | duration “00:01” quoted because 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]” | 🟢 | 26.9.23 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) | 🟢 | 2026-0924-0241 |
| 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) | 🟢 | 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 &) |
🟢 | “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., & 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] | 🟢 | |
| 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 “Simvastatin is an inexpensive oral medication from the statin family that lowers low-density lipoprotein cholesterol” |
| 7.2 | [at_a_glance] is dense, execution-oriented summary of the ER Conclusion section |
🟢 | Condenses ER Conclusion paragraphs 1-2 |
| 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; LDL spelled out |
| 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 (drug item split into two) |
| 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 clause “, for whom an alternative statin is used” 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). | 🟢 | Child-Pugh Class C, ALT >3x ULN, eGFR <30 and 5 mg threshold 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 | No ranking notation in ER |
| 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 Key Interactions from the ER, excluding any that are already listed as Contraindications | 🟢 | All 12 non-contraindication ER interaction bullets present; strong CYP3A4 inhibitors and gemfibrozil/cyclosporine/danazol excluded |
| 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). | 🟢 | Dose caps (10 mg / 20 mg), niacin 1 g/day threshold and example drug lists 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. | N/A | No ranking notation in ER |
| 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. | 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 | ER Protocol has more than three 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 | 🟢 | All three aspects from ER line 360 |
| 11.2 | The sets are picked and ordered by the magnitude of the related benefit | 🟢 | Clinical event reduction first, then maximum and initial LDL lowering |
| 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 | ER provides 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 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. | 🟢 | Items use ER headings only |
| 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 tiers populated in ER |
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 use ER headings only |
| 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. | N/A | All four tiers populated in ER |
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 12 ER table 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. |
🟢 | Cadence matches ER lines 376-378 |
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 verbatim |
Issues 24/09/2026 02:46
Pass rate 100.00%. No issues found.
Issues 24/09/2026 02:44
- 1.3 — Optional SLCO1B1 test presented as routine: The monitoring cadence (line 742) reads “lipoprotein(a) and SLCO1B1 once”, dropping the ER’s framing of “optional SLCO1B1 genotyping” in its Monitoring Protocol section.
Fixes 24/09/2026 02:44
- 1.3 — Optional SLCO1B1 test presented as routine: Changed the monitoring cadence ending from “lipoprotein(a) and SLCO1B1 once” to “lipoprotein(a) once; optional one-time SLCO1B1 genotyping”, matching the ER wording.