Audit: QRS - Spermidine for Health & Longevity

Audit conducted on 13/08/2026 03:04 using AI4L / Opus 5

Summary

Items	Count
Total	93
Passed	85
Failed	0
N/A	8
Pass Rate	100.00%

Total = Passed + Failed + N/A
Pass Rate = Passed / (Passed + Failed) x 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.	🟢	Protocol cells trace to ER lines 308/311/313/315; time-to-effect cells to ER line 345; benefits/risks to ER benefit and risk headings; monitoring table to ER lines 370-379; qualitative list to ER lines 383-388.
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.	🟢	The ER’s “Conflicted” flags are carried through as “— conflicted” on mortality, memory and tumour-growth items; “tissue delivery is unresolved” mirrors ER line 409.
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”).	🟢	Pregnancy/breastfeeding/under-18 and advanced kidney disease remain under Contraindications, not Key Interactions; population restrictions (“in poor responders”, “in older adults at risk of dementia”) are retained.
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.	🟢	Every gate item comes from ER `Key Interactions & Contraindications` (lines 274-292); no content from `Benefit-Modifying Factors` or `Risk-Modifying Factors` appears in the gates.
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 identifiers, author names or brand names (spermidineLIFE, Primeadine, Chrysea, TLL) appear anywhere in the QRS.
1.6	The QRS does not introduce new attributions.	🟢	No attributions of any kind are 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.	🟢	Measured, non-promotional register throughout; British spellings (“tumour”, “authorisation”) match the ER.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Technical terms are used where the ER uses them, and the At-A-Glance and monitoring content stay factual and actionable.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Content is stated as evidence and observed practice rather than instruction.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperative directed at a reader; targets and cadence are reproduced as the ER states them.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No “recommended”, “advised”, or “should” constructions in the document’s own voice.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No occurrence of “you”, “your”, “yours” or “yourself” anywhere in the file.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms are limited to biomarker and drug names required for precision; “estimated glomerular filtration rate” and “immunoglobulin E-mediated” are spelled out rather than abbreviated.
2.8	Information is presented in a concise and very compact manner	🟢	Gate items are single clauses; benefit and risk tiers are semicolon-separated fragments with all magnitudes stripped.
2.9	It DOES NOT address the reader directly	🟢	Confirmed — no second-person pronouns in the file.
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.	🟢	Optimal functional ranges (hs-CRP below 0.5 mg/L, fasting insulin 2-5 uIU/mL) rather than conventional laboratory limits address exactly this audience.
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.	🟢	24-hour ambulatory blood pressure, a 10-marker panel and a food-first dietary route all assume willingness to act.
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.	🟢	Nothing is simplified toward a general-population reader; the sheet retains research-assay markers such as plasma spermidine.
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.	🟢	The At-A-Glance leads with the unresolved pharmacokinetics and the conflicting Japanese cohort, the two facts that most change the decision for a proactive user.
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.	🟢	“anti-aging” does not occur; the title uses “Health & Longevity”.
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.	🟢	“Gastrointestinal discomfort”, “adverse”-register wording and full biomarker names are used; no consumer-grade substitutes appear.

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 verified byte-identical to the template at lines 445, 491, 541, 571, 590, 614, 641, 645-647, 803.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 38 template variable spans are present; the repeatable marker_#* and qualitative_item# spans are correctly expanded to marker_1..10 and qualitative_item_1..6.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	A full diff of the QRS against the template shows differences only inside data-qrs-var spans, the title, and the metadata block; CSS, structure, website=”…” spans and the footer disclaimer are untouched.

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 that feeds the QRS is empty, so the condition does not arise.
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.	🟢	“Standard supplemental dose”, “Best time of day” and “Food-first route” are the ER’s bold labels verbatim (ER lines 308, 313, 311); monitoring row labels are the ER biomarker names verbatim.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Time-to-effect labels are taken from the ER’s own benefit headings (“All-cause mortality”, “Memory performance”, “Vaccine antibody response”), as the ER’s single “Time to effect” bullet supplies no per-item bold label.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji characters occur in the file; tier emphasis is carried by the CSS palettes and the bold “Medium:”/”Low:”/”Speculative:” 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 discretionary section is condensed: benefits and risks are reduced to heading fragments with all magnitudes dropped, gate items to single clauses, and the At-A-Glance to 55 words. Remaining length is driven by the exhaustive-listing requirements of items 14.2 and 15.2.

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.	🟢	Lines 2-14; the comment opens immediately after the doctype on line 1 and precedes the template comment on line 16.
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.	🟢	Opening “—” on line 3, closing “—” on line 13; the preamble text “QRS — Metadata (invisible, parsed by audit tooling)” precedes the opening delimiter.
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; none of the values are repeated in the head or body.
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: "00:03"` is quoted, and it contains a colon; all other values are unquoted and untrimmed of nothing.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	Line 4: `er_filename: spermidine_2026-0813-0011_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]”	🟢	Line 5: `qrs_prompt_version: 26.7.02`, matching the version badge at the top of 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)	🟢	Line 6: `qrs_creation_date: 2026-0813-0255`.
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢	Line 7: `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 with no version or qualifier.
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢	Line 8: `qrs_creator_ai_fullname: Opus 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” is nickname plus version only; the context-window qualifier is correctly omitted.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	Line 9: `qrs_filename: spermidine_2026-0813-0011_Opus_QRS.html`, matching the file on disk.
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.	🟢	Re-verified across all nine keys; no stray whitespace or unnecessary quoting.

#	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 `&`)	🟢	Line 22: `Spermidine for Health & Longevity - Quick Reference Sheet`, matching ER `canonical_topic` with the ampersand encoded.
6.2	[header_topic] is set to the [canonical_topic] of the ER `frontmatter`, with HTML entities encoded as needed (e.g., `&` for `&`)	🟢	Line 417: `Spermidine for Health & Longevity`.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	Line 421: `08/13/2026`, the correct reformatting of `2026-0813-0255`.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	Line 425: `Opus 5`, matching the frontmatter value.
6.5	No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker.	🟢	The header contains only the title and the template subline; the ER’s “Also known as” line is correctly not carried over.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER `Conclusion` section	🟢	Condenses ER lines 405 and 409 into the mechanism, the supporting evidence base, the contradicting cohort, and the unresolved delivery question.
7.2	[at_a_glance] is no longer than 60 words	🟢	55 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Recycling of worn cell parts and the animal/population case map to ER line 405; the Japanese null result and cancer-death hint to ER line 405; unmoved blood levels to ER line 409.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	Uses “food-derived molecule”, “helps cells recycle worn parts”, “population studies” and “blood levels”; autophagy and pharmacokinetics are described rather than named.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial name, author, year or sample size appears; “a large Japanese population” is a generic reference.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No hazard ratios, confidence intervals, effect sizes or p-values are present.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER `Key Interactions & Contraindications` section	🟢	All six items map to ER lines 274-275 and the “Populations who should avoid Spermidine” list at ER lines 288-292.
8.2	[stop_items] represent the Contraindications from the ER	🟢	Active/recent malignancy, eflornithine, polyamine-restricted diets, celiac/wheat allergy, advanced kidney disease, and pregnancy/breastfeeding/under-18 — the ER’s complete avoid list.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Six `<li>` elements at lines 574-585 inside the `stop_items` span.
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.	🟢	The ER’s rationales are stripped: “given that tumours import dietary polyamines” (line 288) and “where no safety data exist at any dose” (line 292) do not appear, and no item carries a trailing dash clause.
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).	🟢	The 12-month cancer window, the “below 30 mL/min/1.73 m², or dialysis” threshold, the “biopsy-confirmed” and “immunoglobulin E-mediated” severity qualifiers, and the “any wheat-germ-derived product” scope are all retained.
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	The ER uses no ranking notation in its contraindication bullets.
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.	🟢	The ER names several such populations, and the section is correctly populated rather than empty.
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	The section is not empty.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER `Key Interactions & Contraindications` section	🟢	All seven items map to ER lines 276-283.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	Eflornithine and polyamine-restricted diets appear only under Contraindications; the ER’s two explicit no-caution bullets (over-the-counter medications, line 280; fasting and time-restricted eating, line 284) are correctly omitted from a decision gate.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Seven `<li>` elements at lines 593-604 inside the `caution_items` span.
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.	🟢	The tyramine/hypertensive-crisis explanation (ER line 277), the rapamycin redundancy rationale (line 279) and the staggered-introduction advice (line 282) are all stripped; no item carries a trailing dash clause.
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).	🟢	Named examples are preserved throughout: ramipril/losartan/amlodipine, phenelzine/tranylcypromine, hydroxychloroquine/chloroquine, dietary nitrate/garlic/magnesium/hibiscus/omega-3, and urolithin A/resveratrol/green tea catechins.
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	The ER uses no ranking notation in its interaction bullets.
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.	🟢	The ER names several such interactions, and the section is correctly populated rather than empty.
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	The section is not empty.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER `Protocol` section	🟢	All three cells trace to the ER `Therapeutic Protocol` bullets at lines 308, 311, 313 and 315.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER `Protocol` section	🟢	Dose, timing and dietary route are the three decisions a user must actually make; the remaining ER bullets are background, sex/age caveats or competing-approach history.
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	The ER supplies more than three actionable aspects, so no set is unused.
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER `Protocol` section.	🟢	Lines 449-487; each label, value and sub carries substantive ER-derived content, including the 6 mg novel-food cap and the 7-12 mg habitual-intake baseline.

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	🟢	The ER’s `Time to effect` bullet (line 345) names exactly three horizons — decades for mortality, three months for cognition, thirteen weeks for the vaccine pilot — and all three are carried over.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	All-cause mortality (ER Medium tier) is first, followed by memory performance and vaccine antibody response (both ER Low tier, in the ER’s own order).
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	The ER supplies three distinct time-to-effect aspects, so no set is unused.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢	Lines 497-533; each sub reproduces the ER’s own qualification, including “nothing measurable in weeks” and “in poor responders only”.
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 does provide time-to-effect information at line 345, so the section is correctly retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER `Expected Benefits` section	🟢	Every listed benefit corresponds to an ER `Expected Benefits` heading at lines 148-200.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present at lines 543, 546, 551, 559.
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.	🟢	Reduced to heading fragments; the hazard ratio 0.76, Cohen’s d 0.77, the 2.23-point MMSE gain and the 48%-versus-79% figure are all absent.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses occur anywhere in the four benefit spans.
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.	🟢	The ER has no High-tier benefit, and `benefits_high` carries `style="display: none"` at line 543 with the template placeholder left untouched rather than an empty-state phrase.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER `Potential Risks & Side Effects` section	🟢	Every listed risk corresponds to an ER `Potential Risks & Side Effects` heading at lines 220-260.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present at lines 616, 619, 625, 630.
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.	🟢	Reduced to heading fragments; the 1.38 cancer-mortality hazard ratio, its confidence interval and trend p-value, and the 2025 recall detail are all absent.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses occur anywhere in the four risk spans.
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.	🟢	The ER has no High-tier risk, and `risks_high` carries `style="display: none"` at line 616 with the template placeholder left untouched rather than an empty-state phrase.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER `Monitoring` section	🟢	The table reproduces the ER `Monitoring Protocol & Defining Success` table at lines 368-379, using the ER’s own “Optimal Functional Range” and “Why Measure It?” text.
14.2	All measurable/quantifiable biomarkers from the `Monitoring` section are listed	🟢	All ten ER biomarkers are present in ER order: hs-CRP, 24-hour ambulatory blood pressure, eGFR, ALT, fasting insulin, triglyceride/HDL ratio, complete blood count, homocysteine, plasma spermidine, tissue transglutaminase IgA.
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.	🟢	Lines 793-797 reproduce the ER’s schedule from lines 364 and 366, including the baseline draw, the 3-month and 12-month panels, and the twice-daily home blood-pressure checks for anyone on antihypertensives.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER `Monitoring` section	🟢	Taken from the ER’s “Qualitative markers worth tracking alongside the laboratory values” list at lines 383-388.
15.2	All subjective/qualitative biomarkers from the `Monitoring` section are listed	🟢	All six ER qualitative markers are present in ER order, at lines 806-833.

Issues 13/08/2026 03:04

Pass rate 100.00%. No issues found.