Audit: QRS - Therapeutic Plasma Exchange for Health & Longevity

Audit conducted on 29/08/2026 07:13 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	93
Passed	83
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

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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.	🟢	Every protocol cell, time-to-effect cell, benefit, risk, gate item, marker row, cadence sentence and qualitative item traces to a literal ER passage (ER lines 147–204, 225–281, 319–328, 299–315, 352–360, 405, 435–455).
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.	🟢	ER hedges are carried through: “short-lived”, “mostly preventable”, “Difference no longer present at the later timepoint”, “No established target; track change from the individual’s own baseline”.
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”).	🟢	All ten contraindications remain absolute avoidance statements; all thresholds and time windows retain their original direction and magnitude.
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 gate draws only on the ER “Populations who should avoid” list; Key Interactions gate draws only on the ER interaction bullets; no Benefit- or Risk-Modifying Factor appears in either gate.
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, no NCT identifiers, no “et al.”, no author names and no product brand names appear anywhere in the QRS.
1.6	The QRS does not introduce new attributions.	🟢	No attribution of any kind is present in the QRS body.

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.	🟢	The measured, conflict-aware register of the ER Conclusion is preserved in the At-A-Glance and throughout.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Clinical precision in the gates and monitoring table is paired with an actionable protocol panel and a preventability framing of the harms.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Content is stated descriptively (noun phrases and impersonal constructions); no imperatives are directed at a patient.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No prescriptive verbs; the cadence line lists a schedule rather than instructing anyone to follow it.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No instances of “recommend”, “advise”, “should”, or equivalent guidance framing.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the document.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	The At-A-Glance is fully plain; clinical terms elsewhere are decision-gate and biomarker terms carried verbatim from the ER, where precision is load-bearing.
2.8	Information is presented in a concise and very compact manner	🟢	Gate items, benefit and risk tiers, and marker rows are stripped to the key fact with no mechanistic rationale or citation carried over.
2.9	It DOES NOT address the reader directly	🟢	Confirmed by full-text scan; no direct address.
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.	🟢	Content selection (longevity schedule, epigenetic age panel, baseline-dependence of response) targets 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.	🟢	A six-session clinic-administered course with a ten-marker laboratory panel is presented without hedging on burden or cost.
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.	🟢	Assumes access to apheresis facilities and specialist laboratory testing; no general-population simplification.
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 surfaces the ER’s key limitation for an optimised individual — gains “concentrated in those starting in poorer health”.
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.	🟢	“Longevity protocol” and “longevity trials” are used; “anti-aging” appears nowhere.
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.	🟢	Formal register throughout (“haemodynamic instability”, “coagulopathy”, “anaphylaxis”, “prothrombin time / INR”).

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, gate headings, tier labels and table column headers are byte-identical to the template.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 34 template variables present; the marker_#* and qualitative_item# repeaters are expanded to 10 and 6 instances respectively.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	The website=”evidence_review”, website=”audit” and website=”full_review” spans are unchanged; the inline stylesheet is byte-identical to the 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”	N/A	No source ER section mapped 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.	🟢	“Core procedure” and “Best time of day” are verbatim ER bold labels; “Longevity protocol” carries the ER bold label with only its source-attribution parenthetical removed under rule 1.5.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Marker names and qualitative items are verbatim ER table and bullet text; protocol labels are verbatim ER bold labels.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	Full-text scan returns no emoji code points; the ER’s “⚠️ Conflicted” markers were correctly dropped.
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 section is condensed to its minimum mandated content: benefit and risk subsections collapsed to one line per tier, gate items stripped of glosses and mechanism, marker “Why” cells reduced to a single clause.

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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; it is the first element after the doctype on line 1.
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.
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; no metadata value is echoed into visible markup.
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.	🟢	All values trimmed; only duration: "00:03" is quoted, correctly so because it contains a colon.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	Line 4: er_filename: therapeutic_plasma_exchange_2026-0829-0449_Opus_ER.md, matching the ER on disk.
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 QRS.md version badge.
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: 2026-0829-0706, correct format.
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” — single word, no version.
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” — nickname plus version, no qualifier.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	Line 9: qrs_filename: therapeutic_plasma_exchange_2026-0829-0449_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; consistent and clean.

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 &)	🟢	Line 22: “Therapeutic Plasma Exchange for Health & Longevity - Quick Reference Sheet”, matching the 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: “Therapeutic Plasma Exchange for Health & Longevity”.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	Line 421: “08/29/2026”, correctly derived from qrs_creation_date 2026-0829-0706.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	Line 425: “Opus 5”, matching the frontmatter.
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 div contains only the title and the template subline; the ER “Also known as” line was 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	🟢	Compresses all four Conclusion paragraphs (ER lines 477–483) into the decision-relevant core: what the procedure is, the strength of evidence, the character of the gains, and the harm profile.
7.2	[at_a_glance] is no longer than 60 words	🟢	57 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Maps to ER 477 (procedure and disease record), 477 (one small trial in healthy adults), 479 (short-lived, laboratory measures, poorer-health concentration) and 481 (harms common but preventable).
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; “liquid part of the blood”, “protein solution” and “laboratory measures of biological age” are plain-language renderings.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	“one small trial” carries no name, year, sample size or p-value.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No numeric result of any kind appears.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All items derive from the “Populations who should avoid Therapeutic Plasma Exchange” list at ER lines 317–328.
8.2	[stop_items] represent the Contraindications from the ER	🟢	All ten ER contraindications are present, in ER order, with none added or omitted.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Ten discrete <li> elements inside the stop_items span (lines 566–592).
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 dashes or trailing clauses; the ER’s plain-language gloss “(drugs given to raise dangerously low blood pressure)” was correctly stripped from item 1.
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).	🟢	“NYHA Class IV”, “below 30%”, “within the preceding 90 days”, “fibrinogen below 100 mg/dL”, “platelet count below 50 × 10⁹/L” and “ionised calcium below 1.0 mmol/L” are all 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	The ER uses no ranking notation inside parentheses in this section.
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 ten such populations and the section is correctly populated rather than left 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 items derive from the interaction bullets at ER lines 299–315.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	All nine ER interaction bullets are present in ER order; none duplicates a contraindication.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Nine discrete <li> elements inside the caution_items span (lines 598–621).
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.	🟢	Every ER “Caution/Monitor — rationale. Mitigation: …” trailing clause is stripped, including the Weinstein attribution and the 1994-series citation on the calcium bullet.
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).	🟢	All seven ER example-drug lists are preserved in full; only the plain-language class glosses (“blood-pressure drugs:”, “painkillers:”, “laboratory-made antibody drugs:”) were trimmed.
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 inside parentheses in this section.
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 nine such interactions and the section is correctly populated rather than left 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 derive from the ER Therapeutic Protocol bullets at lines 352, 354 and 360.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Dose/schedule (longevity protocol), what is actually done and with which replacement fluid (core procedure), and timing (best time of day) — the three bullets an implementer must act on; the disease-specific Alzheimer’s protocol and the non-actionable discussion bullets were correctly not selected.
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 three or more distinct actionable aspects and all three sets are used.
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section.	🟢	All nine fields carry substantive ER-derived content; no placeholder or empty field remains.

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 “Time to effect” bullet (line 405) names exactly three horizons — immediate constituent removal, biological-age change at ~1 month, Alzheimer’s functional change at 6–14 months — and all three are carried.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Ordered High tier (constituent removal, underpinning “Control of Antibody-Mediated Autoimmune Disease”) then the two Medium-tier benefits in ER order (Alzheimer’s decline, then epigenetic age).
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 distinct time-to-effect aspects are present in the ER and all three sets are used.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢	All nine fields are populated; the sub-cells add ER-sourced qualifiers (ER lines 159 and 167) rather than filler.
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, so the section is correctly retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	All nine items are the ER’s #### benefit headings from lines 149–203.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present and populated with the correct tier membership (1 / 2 / 4 / 2), matching the ER exactly.
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.	🟢	Every ER Magnitude: figure (RR 0.62, 52%/61%/71%, 2.61 years, 1.32 years) and every trial name and sponsor is excluded.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any benefit item; the ER’s “⚠️ Conflicted” markers on two Low-tier headings were also correctly dropped.
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 benefit tiers contain items in the ER.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	All nine items are the ER’s #### risk headings from lines 227–281.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present and populated with the correct tier membership (4 / 1 / 2 / 2), matching the ER exactly.
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.	🟢	Every ER Magnitude: frequency (9.1% vs 1.0%, 0.25% of 15,658, 20.1% vs 13.1%, 62% clotting-time prolongation) is excluded.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any risk item; the “⚠️ Conflicted” marker on the infection-risk heading was correctly dropped.
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 risk tiers contain items in the ER.

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 biomarker table (lines 435–446).
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All ten ER biomarkers are present in ER order with Target and Why cells verbatim; the ER’s fourth “Context/Notes” column was correctly not carried into the three-column template.
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.	🟢	Line 806: condenses ER lines 431–433 into baseline, per-session, every-third-session, four-week, one/three-month and six-to-twelve-month intervals.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	All items come from the “Qualitative markers worth tracking alongside the laboratory panel” list at ER lines 448–455.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All six ER qualitative markers are present verbatim and in ER order.

Issues 29/08/2026 07:13

Pass rate 100.00%. No issues found.