Audit: QRS - Tadalafil for Health & Longevity
Audit conducted on 11/04/2026 18:40 using AI4L / Opus 5.5
Summary
| Items | Count |
|---|---|
| Total | 97 |
| Passed | 85 |
| Failed | 0 |
| N/A | 12 |
| 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, time-to-effect, gate, tier, marker and lede statements trace to ER text (e.g., lede to Motivation/Conclusion; action_2_sub verbatim from Therapeutic Protocol). |
| 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. | 🟢 | Hedges kept: “clinical-outcome impact untested” (time_3_sub), “inferred; no human evidence of harm in this group” (melanoma gate), “Would likely increase” (grapefruit), “plausible but unproven” (lede). |
| 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; “Avoid for BPH” → “avoided in enlarged-prostate treatment”, “Avoid” → “Combination avoided” keep the ER force. |
| 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 the ER’s “Populations who should avoid” list, interactions from “Documented”/”Theoretical” lists, risks from Potential Risks tiers. |
| 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 or expert names; the only brand name (Adcirca) appears in the ER’s Other PDE5 inhibitors label. |
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 expert, accessible, objective, and data-driven | 🟢 | |
| 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 second-person address anywhere on the sheet. |
| 2.7 | The QRS is written in plain language, avoiding unnecessary medical jargon | 🟢 | Technical terms are ER labels or decision-gate qualifiers (NYHA, Child-Pugh, CYP3A4); NAION rendered as “sudden vision loss from optic nerve ischemia”. |
| 2.8 | Information is presented in a concise and very compact manner | 🟢 | |
| 2.9 | 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. | 🟢 | |
| 2.10 | The target audience is willing to employ lifestyle and behavioral changes as well as follow protocols that may be inconvenient, costly, or require effort. | 🟢 | |
| 2.11 | 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. | 🟢 | |
| 2.12 | 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 weighs the longevity claim (cohort signal, no randomized survival trial) for a longevity-oriented reader. |
| 2.13 | 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; Protocol label uses “Longevity-oriented”. |
| 2.14 | 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. | 🟢 | Lede uses “prescription oral medication”; no lay route-of-administration phrasing. |
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 | Every element carrying a data-qrs-var attribute in [qrs_template] is present in the QRS with the same name | 🟢 | All template variables present; marker_# and qualitative_item_# expanded to 1–8 and 1–6. |
| 3.3 | Everything outside the data-qrs-var spans — markup, text, styles, comments — is as in the template; spans that no checklist item addresses are left unchanged as well | 🟢 | Head/style and footer identical to template (diffed); metadata comment carries workflow keys duration, git_user, git_issue in addition to template keys. |
4. Formatting
| # | Description | Result | Comments |
|---|---|---|---|
| 4.1 | An empty ER section never produces visible empty-state text in the QRS: the corresponding region is hidden or left empty. Phrases such as “None documented in human trials to date” or “Not formally studied” appear only where the ER uses them for a fact the QRS carries over. | 🟢 | No empty-state phrases on the sheet. |
| 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 (“Longevity-oriented daily low dose”, “On-demand dosing”, “Best time of day”) and interaction labels are the ER’s bold labels. |
| 4.3 | Labels are not paraphrased, abbreviated, or invented. | 🟢 | Label edits are trims of glosses/example lists only (e.g., “Strong CYP3A4 inhibitors (ketoconazole, ritonavir)”). |
| 4.4 | The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. | 🟢 | |
| 4.5 | The QRS is designed to render on one A4 page. It fails this item only for one of four things: a trailing clause after a dash, an optional gloss, an example list left untrimmed, or a repetition. Nothing else is cut to fit. | 🟢 | No trailing dash clauses, optional glosses, untrimmed long example lists or repetitions found; remaining length is required gate and marker content. |
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. | 🟢 | Only duration is quoted (“00:02”), which 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]” | 🟢 | 26.10.25 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) | 🟢 | 2026-1104-1828 |
| 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 the full name without the version number, with all remaining words joined by hyphens (e.g., Opus, Sonnet, Grok, Gemini-Flash, GPT); when the full name has no version number or is “Unknown”, the nickname equals the full name | 🟢 | |
| 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 model name (the word or words directly before the version number, leaving out the first if there is more than one, e.g., Claude Opus 5.5 → Opus 5.5), the model version number and the variant (if any) as stated in the system prompt or developer instructions of the creating model, with every word capitalized and without product, effort or pricing names (e.g., Opus X.Y, Sonnet X.Y, Grok X.Y, Gemini X.Y Flash, GPT X.Y), the model name alone when the system prompt or developer instructions name a model without a version number (e.g., Grok), or “Unknown” when neither the system prompt nor the developer instructions of the creating model name a model | 🟢 | Opus 5.5 |
| 5.12 | The filename of the document is stated as “qrs_filename: [filename of this document]” | 🟢 |
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 &) |
🟢 | |
| 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] | 🟢 | 11/04/2026 |
| 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 “Tadalafil is an inexpensive generic prescription oral medication that widens blood vessels … used for erectile problems and enlarged-prostate urinary symptoms”. |
| 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. |
| 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 9 ER “Populations who should avoid Tadalafil” entries 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). | 🟢 | 90 days, 6 months, NYHA Class 2, 90/50 mmHg, Child-Pugh Class C, 30 mL/min and 48-hour nitrate window 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 | ER uses no ranking notation. |
| 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 |
🟢 | |
| 9.2 | [caution_items] represent the ER’s documented interactions — the items under its “Documented interactions:” label — excluding any that are already listed as Contraindications and any entry phrased as no interaction found | 🟢 | 8 documented items; nitrates and riociguat sit in Contraindications; tamsulosin, silodosin, finasteride, L-arginine, garlic, antacids, aspirin, warfarin group (no interaction) excluded. |
| 9.3 | [caution_theoretical_items] represent the ER’s theoretical interactions — the items under its “Theoretical interactions (inferred from mechanism, not studied in humans):” label | 🟢 | All 7 theoretical items present. |
| 9.4 | The ER placeholder “None identified” is never an item: it means that group is empty | 🟢 | ER has no “None identified” placeholder; none appears as an item. |
| 9.5 | Individual [caution_items] and [caution_theoretical_items] are formatted as <li></li>. The template’s bold “Theoretical (inferred from mechanism)” sub-heading is the only marker of the second list’s status: no item carries “(theoretical)”, “inferred from” or a mechanism clause | 🟢 | |
| 9.6 | 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. | 🟢 | |
| 9.7 | 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 lists kept in trimmed form; 5-unit alcohol threshold and CYP3A4-inhibitor dose limits kept. |
| 9.8 | 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. |
| 9.9 | If the ER’s theoretical group is empty, the whole Theoretical block — the caution_theoretical span with its sub-heading and list — is hidden with style="display:none", not removed: its spans stay in place, empty. |
N/A | ER theoretical group is not empty. |
| 9.10 | 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. |
| 9.11 | 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, and the Theoretical block is hidden per 9.9. E.g. | N/A | Section is not empty. |
10. Protocol
| # | Description | Result | Comments |
|---|---|---|---|
| 10.1 | The section is derived from the ER Therapeutic Protocol section |
🟢 | |
| 10.2 | The three sets of [action] items cover the three most important actionable implementation aspects from that section | 🟢 | Daily low dose, on-demand dosing, and best time of day. |
| 10.3 | If fewer than three distinct actionable implementation aspects are mentioned in the ER, the unused sets are left empty and hidden with style="display:none", not filled with placeholder text or empty-state phrasing. |
N/A | ER gives more than three actionable aspects. |
| 10.4 | All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from that 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 | 🟢 | Erectile effect, urinary symptoms, blood-vessel lining function from ER Practical Considerations. |
| 11.2 | The sets are picked and ordered by the magnitude of the related benefit | 🟢 | Two High-tier benefits first, then a Low-tier one. |
| 11.3 | If fewer than three distinct time-to-effect aspects are mentioned in the ER, the unused sets are left empty and hidden with style="display:none", not filled with placeholder text or empty-state phrasing. |
N/A | ER gives at least 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 provides no information on time to effect at all, the whole Time to effect block (its subhead and all three sets) is hidden with style="display:none", not removed: its spans stay in place, empty. |
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. | 🟢 | |
| 12.4 | Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | |
| 12.5 | If a tier (high, medium, low, speculative) has no items, its span is hidden with style="display:none", not filled with “None documented in human trials to date” or similar empty-state phrasing. |
N/A | All four tiers have 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] | 🟢 | |
| 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 a tier (high, medium, low, speculative) has no items, its span is hidden with style="display:none", not filled with “None documented in human trials to date” or similar empty-state phrasing. |
N/A | All four tiers have items. |
14. Monitoring
| # | Description | Result | Comments |
|---|---|---|---|
| 14.1 | The section is derived from the ER Monitoring Protocol & Defining Success section |
🟢 | |
| 14.2 | All measurable/quantifiable biomarkers from that section are listed, one table row per marker; the template’s # row is the pattern, repeated with # replaced by 1, 2, 3 … in the data-qrs-var names |
🟢 | All 8 ER table markers listed, numbered 1–8. |
| 14.3 | [marker_#name] is the marker, [marker#target] its target value or range as given in the ER, [marker#_why] its purpose in a few words; a target the ER does not give is written “Not specified in the ER” | 🟢 | |
| 14.4 | [monitoring_cadence] is populated with the monitoring cadence/frequency derived from that section. It is not left with placeholder text or empty. | 🟢 | |
| 14.5 | If the ER names no measurable biomarker, the table is hidden with style="display:none" and the single # row is left as in the template |
N/A | ER names measurable biomarkers. |
15. Qualitative Assessment
| # | Description | Result | Comments |
|---|---|---|---|
| 15.1 | The section is derived from the ER Monitoring Protocol & Defining Success section |
🟢 | |
| 15.2 | All subjective/qualitative markers from that section are listed, one <li> per marker; the template’s # item is the pattern, repeated with # replaced by 1, 2, 3 … |
🟢 | All 6 ER qualitative markers listed. |
| 15.3 | If the ER names no qualitative marker, the card’s list is hidden with style="display:none" and the single # item is left as in the template |
N/A | ER names qualitative markers. |
Issues 11/04/2026 18:40
Pass rate 100.00%. No issues found.
Issues 11/04/2026 18:38
- 2.7 — Jargon replaces ER plain terms: Contraindication text at line 550 uses “Myocardial infarction” where the ER supplies “heart attack”, and interaction text at lines 569 and 587 uses “Orthostatic hypotension” / “orthostatic dizziness” where the ER glosses a blood-pressure drop on standing; none of these terms is part of an ER bold label.
Fixes 11/04/2026 18:38
- 2.7 — Jargon replaced with plain terms: Changed “Myocardial infarction” to “Heart attack” in the contraindication at line 550, “Orthostatic hypotension and dizziness” to “Blood-pressure drop on standing and dizziness” in the alcohol interaction at line 569, and “Possible orthostatic dizziness” to “Possible dizziness on standing” in the sauna item at line 587.
Issues 11/04/2026 18:33
- 7.2 — Lede omits Conclusion safety: The at_a_glance span at line 439 covers only the Conclusion’s benefit and longevity paragraphs and leaves out its safety paragraph, including the dangerous blood pressure drops with nitrate heart medications (ER line 540).
Fixes 11/04/2026 18:33
- 7.2 — Lede adds nitrate safety: Condensed the at_a_glance wording and added the Conclusion’s key safety point, “With nitrate heart medications, blood pressure can drop dangerously.”, keeping the lede at 70 words.
Issues 11/04/2026 18:31
- 1.1 / 1.3 — Overgeneralized dose-rationale claim: Protocol action_1_sub (line 456) says “no published dose rationale for longevity use”, while the ER says only that neither Kahn nor AgelessRx publishes a dose rationale.
- 2.6 — Imperatives address reader: The alpha-blocker interaction (line 564) says “avoid for BPH” and the other-PDE5-inhibitor interaction (line 570) opens with “Avoid;”, both bare imperatives.
- 2.7 — Unexpanded medical acronyms: “BPH” and “ED” in the alpha-blocker item content (line 564) and “Prior NAION” (line 554) are left as unexplained acronyms.
Fixes 11/04/2026 18:31
- 1.1 / 1.3 — Overgeneralized dose-rationale claim: Changed action_1_sub from “no published dose rationale for longevity use” to “the longevity prescribers named in the review publish no dose rationale”, matching the ER’s “neither publishes a dose rationale”.
- 2.6 — Imperatives address reader: Replaced “avoid for BPH” with “avoided in enlarged-prostate treatment” in the alpha-blocker item, and “Avoid;” with “Combination avoided;” in the other-PDE5-inhibitor item.
- 2.7 — Unexpanded medical acronyms: Replaced “BPH” and “ED” in the alpha-blocker item with “enlarged-prostate treatment” and “erectile dysfunction”, and “Prior NAION” with “Prior sudden vision loss from optic nerve ischemia” (the ER’s own risk label for NAION).