Audit: QRS - Spilanthes acmella for Skin Rejuvenation

Audit conducted on 28/09/2026 05:24 using AI4L / Opus 5.5

Iterations

Summary

Items Count
Total 94
Passed 87
Failed 0
N/A 7
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 items trace to ER Expected Benefits, Risks, Key Interactions & Contraindications, Therapeutic Protocol, Practical Considerations, Monitoring and Conclusion.
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” (CYP2E1) and “oral use” / “oral Acmella only” qualifiers carried over.
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”). 🟢 “Immediate expression-line relaxation” keeps the ER’s conflicted flag; no strengthening or softening found.
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. 🟢  
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. 🟢  
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 🟢  
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. 🟢  
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. 🟢  

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 “…” from the [qrs_template] are present in the the QRS. 🟢 All 26 template spans present; marker_#/qualitative_item_# expanded to 5 and 4 rows.
3.3 Spans that are not addressed in a checklist item are left unchanged 🟢 website spans and footer unchanged versus template.

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” 🟢 Empty ER High tiers are hidden per 12.5/13.5 rather than filled.
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 topical regimen”, “Concentration”, “Pre-existing conditions” match ER bold labels.
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 found in QRS source.
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. 🟢  

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 “00:00” 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]” 🟢  
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., &amp; for &) 🟢 “Spilanthes acmella for Skin Rejuvenation - 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 &) 🟢  
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢 2026-0928-0510 → 09/28/2026.
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 “a tingling, numbing tropical herb whose flower extract is sold as a skin-care ingredient for smoothing facial lines”.
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 🟢 70 words (script count).
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 four 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). 🟢  
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 the ER 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. 🟢  
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 populated.

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 🟢 Antiandrogens and skin procedures omitted as already covered by contraindications; botulinum toxin (no interaction) 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). 🟢  
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 the ER 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. 🟢  
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 populated.

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 🟢 Regimen, concentration, pre-existing-condition start.
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 offers more than 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 🟢  
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢 Wrinkles and hydration (Medium) before firmness (Low).
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 distinct 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 data (Expected Benefits, Practical Considerations).

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 is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing. 🟢 benefits_high set to display: none.

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. 🟢  
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 set to display: none.

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 five 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. 🟢  

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 four ER qualitative markers listed verbatim.

Issues 28/09/2026 05:24

Pass rate 100.00%. No issues found.

Issues 28/09/2026 05:19

  1. 2.7 — Unexplained specialist term Demodex: The Speculative benefits line (line 531) uses “anti-Demodex activity”, a specialist term a non-specialist would not know; the ER glosses Demodex as hair-follicle mites and frames the topic as “anti-mite”.

Fixes 28/09/2026 05:19

  1. 2.7 — Replaced Demodex specialist term: Changed “anti-Demodex activity” to “anti-mite activity” in the Speculative benefits line, matching the ER’s own “anti-mite” framing.

Issues 28/09/2026 05:16

  1. 1.2 — Cautious target phrasing dropped: Monitoring targets for facial photographs (line 604, “Change from own baseline”) and skin hydration (line 615, “Rise from own baseline”) omit the ER’s “No established target” qualifier (ER lines 374–375).
  2. 2.7 — Unexplained CYP2E1 jargon: Key Interactions item “CYP2E1 substrates (chlorzoxazone, isoflurane, sevoflurane), theoretical” (line 560) uses specialist terms without the plain-language gloss the ER provides (“a liver enzyme that breaks down some anesthetics and alcohol”, ER line 289).

Fixes 28/09/2026 05:16

  1. 1.2 — Cautious target phrasing restored: Changed marker_1_target from “Change from own baseline” to “No established target; change from own baseline” and marker_2_target from “Rise from own baseline” to “No established target; rise from own baseline”, matching the ER.
  2. 2.7 — CYP2E1 jargon explained: Replaced “CYP2E1 substrates (…)” with “Drugs broken down by the liver enzyme CYP2E1 (…)” in Key Interactions, using the ER’s plain-language gloss.

Issues 28/09/2026 05:13

  1. 7.2 — Lede omits key safety caveat: The at-a-glance text (line 433) summarizes the Conclusion’s benefit and evidence paragraphs but drops its risk paragraph (tingling/numbness and possible daisy-family plant allergy), leaving only “low-risk addition” as the execution-relevant safety takeaway.

Fixes 28/09/2026 05:13

  1. 7.2 — Lede safety caveat added: Rewrote the at-a-glance text to add the ER Conclusion’s main concerns (“tingling and possible daisy-family plant allergy”) and tightened wording elsewhere to stay within 70 words.