Audit: QRS - Topical Dutasteride for Hair Regrowth

Audit conducted on 21/09/2026 21:02 using AI4L / Opus 5

Iterations

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) × 100
  • N/A items are excluded from the pass rate calculation

1. General Rules

# Description Result Comments
1.1 Every claim, magnitude, label, recommendation, and statement in the QRS is literally supported by content in the source ER. 🟢 Spot-checked every populated span. Protocol cells trace to ER Therapeutic Protocol (ER 330, 332, 334); time cells to ER Practical Considerations (ER 387) and Monitoring Protocol & Defining Success (ER 415); marker rows and cadence to the ER biomarker table (ER 419-425) and ER 415; qualitative items to ER 429-433.
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 hedges are carried over: “Sparsely studied” in at-a-glance mirrors ER 459; Speculative-tier framing is preserved for both benefits and risks.
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”). 🟢 Contraindications remain absolute exclusions (QRS 543-549) exactly as ER 302-308 states them; interactions remain interactions, not prohibitions.
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. 🟢 All stop_items come from the ER’s “Populations who should avoid” list; all caution_items from the ER’s interaction bullets. No Benefit- or Risk-Modifying Factor content 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 numbers, author names or brand names appear anywhere in the QRS; named drugs (tamsulosin, verapamil, minoxidil, etc.) are all present in ER 282-298.
1.6 The QRS does not introduce new attributions. 🟢 No attributions of any kind 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. 🟢 Measured, evidence-weighted register matching the ER, including the ER’s own caveat about the commercial tilt of the evidence base (ER 459 → QRS 433).
2.2 The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging 🟢 Tiered benefits/risks, concrete protocols and measurable targets give the reader an actionable frame without overselling.
2.3 The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor 🟢 All content is stated descriptively (“one session every 3 months after an initial closer-spaced induction”), never as instruction to an individual.
2.4 The QRS avoids language that implies medical or clinical advice 🟢 No imperatives or recommendations; the footer disclaimer is the template’s own.
2.5 The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” 🟢 Monitoring cadence and qualitative items use passive, descriptive constructions (“repeated at 3 months”, “photographed monthly under identical conditions”).
2.6 The QRS never addresses “the reader” directly — it presents evidence, not guidance 🟢 No second-person pronouns anywhere in the QRS.
2.7 The QRS is written in plain language, avoiding unnecessary medical jargon 🟢 Technical terms are limited to those the ER requires (dihydrotestosterone, 5-alpha reductase, CYP3A4); the lede replaces them with plain-language equivalents.
2.8 Information is presented in a concise and very compact manner 🟢 Every gate, tier and table cell is a stripped-down fact; no explanatory clauses survive.
2.9 It DOES NOT address the reader directly 🟢 Confirmed: no “you”/”your” in the QRS.
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 assumes a reader willing to track trichoscopic density, run a functional biomarker panel and source a compounded preparation.
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. 🟢 Quarterly intradermal sessions, weekly shed counts and monthly standardized photographs are presented without hedging on inconvenience.
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. 🟢 Functional biomarker targets (e.g., ferritin 70-150 ng/mL, TSH 0.5-2.0 mIU/L) are tighter than conventional lab ranges, signalling the optimizing audience.
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 names both the efficacy shortfall against the oral route and the commercial tilt, which is the decision-relevant weighting 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. 🟢 The string “anti-aging” does not occur in the QRS.
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. 🟢 The lede uses “injections”, “oral dutasteride” and “placebo” rather than the ER conclusion’s lay renderings (“dummy treatment”, “the oral capsule”); “adverse effects” is used throughout the risks card.

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 match the template byte-for-byte (QRS 440, 477, 519, 540, 554, 575, 595, 599-601, 692).
3.2 All “” from the [qrs_template] are present in the the QRS. 🟢 All 34 distinct template variables are present; marker_#* and qualitative_item# are instantiated 7 and 5 times respectively.
3.3 Spans that are not addressed in a checklist item are left unchanged 🟢 A normalized structural diff against the template shows only variable fills and the intended row repetitions; head, styles, footer and website=”” spans 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 section of the source ER is empty; the two empty tiers (Benefits Medium, Risks High) are governed by 12.5 and 13.5 instead.
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 are the ER’s bold labels verbatim: “Standard intradermal protocol”, “Topical solution protocol”, “Microneedling-assisted protocol” (ER 330-334). Marker names match the ER biomarker column verbatim.
4.3 Labels are not paraphrased, abbreviated, or invented. 🟢 No invented labels; time-to-effect labels use the ER’s own wording (“shedding … slows”, “density is stable”, “measurable density gain”, ER 387, 415).
4.4 The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. 🟢 Zero emoji characters in the file; the ER’s ⭕️ and ⚠️ markers were stripped when the Low tiers were carried over.
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 carried item is reduced to its ER heading or label with explanation, magnitude and citation removed; marker 7’s target was shortened from the ER wording to fit. No section was extended beyond the template’s single-page structure.

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. 🟢 QRS 2-14: the metadata comment immediately follows 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 “—” at QRS 3, closing “—” at QRS 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; none of its values are repeated in a rendering element.
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: "00:02" is quoted, correctly so because the value contains a colon.
5.5 The filename of the source ER is stated as “er_filename: [er_filename]” 🟢 QRS 4: er_filename: topical_dutasteride_hair_2026-0921-1818_Opus_ER.md, matching the ER’s own filename field.
5.6 Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]” 🟢 QRS 5: qrs_prompt_version: 26.9.11, matching the version badge in 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) 🟢 QRS 6: qrs_creation_date: 2026-0921-2050, 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]” 🟢 QRS 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]” 🟢 QRS 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]” 🟢 QRS 9 matches the actual filename topical_dutasteride_hair_2026-0921-1818_Opus_QRS.html.
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.

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 &) 🟢 QRS 22: “Topical Dutasteride for Hair Regrowth - Quick Reference Sheet”; canonical_topic at ER 8 matches; no characters require encoding.
6.2 [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., &amp; for &) 🟢 QRS 417: “Topical Dutasteride for Hair Regrowth”.
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢 QRS 421: 09/21/2026, the correct reformatting of 2026-0921-2050.
6.4 [header_subline_model] is set to [qrs_creator_ai_fullname] 🟢 QRS 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. 🟢 Header contains only the title and the template subline; the ER’s “Also known as” line was 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 🟢 QRS 433 condenses all three Conclusion paragraphs (ER 455-459): intent, controlled evidence and its ranking, harm profile, and the state of the evidence base.
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. 🟢 Mechanism/intent → ER 455; three small short controlled studies → ER 455, 457; pooled ranking below oral → ER 457; procedural harms → ER 457; sparsely studied with commercial tilt → ER 459.
7.4 It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead 🟢 Uses “the hair-shrinking hormone” rather than dihydrotestosterone/DHT; no acronyms, no tier or evidence-class jargon.
7.5 It DOES NOT cite specific trials (names, years, sample sizes, p-values) 🟢 Only “Three small, short controlled studies” in the aggregate; no names, years, n or p-values.
7.6 It DOES NOT cite effect sizes, relative risks, or statistical results 🟢 No numbers other than the count of studies.

8. Contraindications

# Description Result Comments
8.1 The section is derived from the ER Key Interactions & Contraindications section 🟢 All seven items map to the “Populations who should avoid Topical Dutasteride” list at ER 300-308.
8.2 [stop_items] represent the Contraindications from the ER 🟢 All seven ER exclusion bullets are present, none added (QRS 543-549).
8.3 Individual [stop_items] are formatted as <li></li> 🟢 Seven discrete <li> elements 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. 🟢 Every “because…”/”where…”/”in whom…” clause from ER 302-308 is stripped (e.g., the hypospadias rationale, the pillowcase-residue clause, the “no dosing, safety or developmental data exist” 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). 🟢 “(Child-Pugh Class C)”, “within 12 months of a prostate biopsy”, “under 18 years” and “until healed” are all retained (QRS 546-549).
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 seven 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 nine items map to the interaction bullets at ER 282-298.
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; none duplicates a contraindication.
9.3 Individual [caution_items] are formatted as <li></li> 🟢 Nine discrete <li> elements inside the caution_items span (QRS 557-565).
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. 🟢 Monitor/Caution verdicts, mechanisms and mitigations are all stripped; the em-dash gloss inside the alpha-blocker parenthesis (“— drugs that relax the prostate and blood vessels”) is removed.
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 example drugs are retained for every bullet that has them, including the NSAID list pulled from the ER body into the analgesics item (ER 292).
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 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 come from ER Therapeutic Protocol bullets at ER 330, 332 and 334.
10.2 The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section 🟢 The three administrable regimens (intradermal, daily topical solution, microneedling-assisted) are selected ahead of the ER’s contextual bullets on competing approaches, popularisers and timing.
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 cells carry ER-derived content; concentrations, volumes, grid spacing, session intervals and durations match ER 330-334 exactly.

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 🟢 Shedding slowing at 2-3 months (ER 387), density stable at 6 months and measurable density gain at 12 months (ER 415) are the only time-to-effect milestones the ER states.
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢 Ordered from the largest related benefit (measurable density gain, the ER’s sole High benefit) through stabilization to the earliest and smallest signal, reduced shedding.
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 provides three distinct time-to-effect aspects, 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 cells populated; the sub-lines quote the ER’s fixed-point baseline, photographic/trichoscopic reassessment and hair-cycle rationale.
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 (ER 387, 415), so the section is correctly retained.

12. Benefits

# Description Result Comments
12.1 The section is derived from the ER Expected Benefits section 🟢 Tiers map to the ER headings at ER 154 (High), 166 and 172 (Low) and 180 (Speculative).
12.2 Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] 🟢 All four spans present (QRS 521-533).
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. 🟢 Each entry is the bare ER heading; all Magnitude figures (62.8% vs 17.5%, 34.5% vs 55.6%, 541-patient cohort) are omitted.
12.4 Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 No parentheses in any benefits entry; the ER’s “⭕️ Not Central to Hair Regrowth” flag on the Low benefit is 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. 🟢 benefits_medium carries style="display: none" with an HTML comment citing ER 162 (“No benefit sits at Medium”); no empty-state text is rendered.

13. Risks

# Description Result Comments
13.1 The section is derived from the ER Potential Risks & Side Effects section 🟢 Tiers map to ER 210 (Medium), 218/224/230 (Low) and 238-264 (Speculative).
13.2 Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] 🟢 All four spans present (QRS 577-589).
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. 🟢 Each entry is the bare ER heading; the 45.5% pain frequency, the RR 1.37 (95% CI 0.81-2.32) and all cohort sizes are omitted.
13.4 Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 No parentheses in any risks entry; the ER’s “⚠️ Conflicted” flag on the sexual adverse effects heading is 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. 🟢 risks_high carries style="display: none" with an HTML comment citing ER 206 (“No risk reaches High”); no empty-state text is rendered.

14. Monitoring

# Description Result Comments
14.1 The section is derived from the ER Monitoring section 🟢 Table and cadence come from ER Monitoring Protocol & Defining Success (ER 415-425).
14.2 All measurable/quantifiable biomarkers from the Monitoring section are listed 🟢 All seven ER biomarker rows are present in order: serum dihydrotestosterone, total testosterone, prostate-specific antigen, alanine aminotransferase, ferritin, thyroid-stimulating hormone, trichoscopic hair density, with targets and rationales verbatim.
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. 🟢 QRS 686 reproduces the ER’s full schedule: baseline, 3 months, 6 months, then 6-12 monthly bloods and annual photographs (ER 415).

15. Qualitative Assessment

# Description Result Comments
15.1 The section is derived from the ER Monitoring section 🟢 Items come from the “Qualitative markers worth tracking alongside the numbers” list at ER 429-433.
15.2 All subjective/qualitative biomarkers from the Monitoring section are listed 🟢 All five ER qualitative markers are carried over verbatim (QRS 695-707).

Issues 21/09/2026 21:02

Pass rate 100.00%. No issues found.

Issues 21/09/2026 20:59

  1. 2.15 — Colloquial “dummy treatment” in lede: [at_a_glance] (line 433) reads “found more regrowth than dummy treatment”, a consumer-grade rendering of “placebo”; 2.15 requires formal clinical terminology on every surface including the lede, and the text is not a direct quote.

Fixes 21/09/2026 20:59

  1. 2.15 — Colloquial “dummy treatment” in lede: Replaced “dummy treatment” with “placebo” in [at_a_glance], so the lede uses the formal clinical term.

Issues 21/09/2026 20:54

  1. 9.4 — Drug list attached to wrong half: The Key Interactions item at QRS line 562 reads “Over-the-counter analgesics and alcohol-containing scalp products (ibuprofen, naproxen, aspirin)”; the ER label (line 292) carries no parenthesis, and as placed the examples read as alcohol-containing scalp products rather than as the analgesics they are.

Fixes 21/09/2026 20:54

  1. 9.4 — Drug list attached to wrong half: Moved the example list so it follows the term it belongs to, changing “Over-the-counter analgesics and alcohol-containing scalp products (ibuprofen, naproxen, aspirin)” to “Over-the-counter analgesics (ibuprofen, naproxen, aspirin) and alcohol-containing scalp products”.