Audit: QRS - Tretinoin for Skin Rejuvenation
Audit conducted on 01/07/2026 00:47 using AI4L / Opus 4.8
Summary
| Items | Count |
|---|---|
| Total | 91 |
| Passed | 81 |
| 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
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 QRS content traces to ER sections (Conclusion, Protocol, Benefits, Risks, Interactions, Monitoring). |
| 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 reproductive concern” and “Speculative” tiers mirror ER cautious phrasing. |
| 1.3 | The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”). | 🟢 | Pregnancy presented as contraindication/avoided, matching ER. |
| 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 and Key Interactions drawn from the ER’s own Key Interactions & Contraindications section; risks from Risks section. |
| 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 citations, PMIDs, NCT IDs, expert names, or brand names appear in the QRS. |
| 1.6 | The QRS does not introduce new attributions. | 🟢 | No attributions present. |
2. Focus, Tone & Audience
| # | Description | Result | Comments |
|---|---|---|---|
| 2.1 | The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing. | 🟢 | Objective, evidence-condensing tone consistent with the ER. |
| 2.2 | The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging | 🟢 | Maintained throughout. |
| 2.3 | The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor | 🟢 | Presents evidence, not directives. |
| 2.4 | The QRS avoids language that implies medical or clinical advice | 🟢 | No advice phrasing; footer disclaimer present. |
| 2.5 | The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” | 🟢 | Descriptive phrasing used throughout. |
| 2.6 | The QRS never addresses “the reader” directly — it presents evidence, not guidance | 🟢 | No second-person address. |
| 2.7 | The QRS is written in plain language, avoiding unnecessary medical jargon | 🟢 | Plain language; technical terms minimized. |
| 2.8 | Information is presented in a concise and very compact manner | 🟢 | Card/cell format is compact. |
| 2.9 | It DOES NOT address the reader directly | 🟢 | Confirmed 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. | 🟢 | Framing fits 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. | 🟢 | Long-term nightly protocol framing fits. |
| 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. | 🟢 | Consistent with proactive 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. | 🟢 | Weighting mirrors ER. |
| 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. | 🟢 | Uses “Skin Rejuvenation”; no “anti-aging” in QRS voice. |
| 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 terminology used. |
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 present and unmodified. |
| 3.2 | All “…” from the [qrs_template] are present in the the QRS. | 🟢 | Full set of named spans present. |
| 3.3 | Spans that are not addressed in a checklist item are left unchanged | 🟢 | No unauthorized span modifications detected. |
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 relevant to 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. | 🟢 | Tier labels (High/Medium/Low/Speculative) and monitoring labels match ER. |
| 4.3 | Labels are not paraphrased, abbreviated, or invented. | 🟢 | Labels faithful to ER. |
| 4.4 | The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels. | 🟢 | No emoji indicators in QRS body. |
| 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. | 🟢 | Content condensed to one-page budget. |
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. | 🟢 | Metadata comment is first element after doctype (lines 2-13). |
| 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. | 🟢 | YAML delimited by — at lines 3 and 12. |
| 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. | 🟢 | Inside HTML comment; not rendered. |
| 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. | 🟢 | Values clean and unquoted. |
| 5.5 | The filename of the source ER is stated as “er_filename: [er_filename]” | 🟢 | er_filename: tretinoin_skin_2026-0701-0003_Opus_ER.md |
| 5.6 | Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]” | 🟢 | qrs_prompt_version: 26.5.18 |
| 5.7 | Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430) | 🟢 | qrs_creation_date: 2026-0701-0027 |
| 5.8 | The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]” | 🟢 | qrs_creator_ai_nickname: Opus |
| 5.9 | The nickname of the AI is just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT) | 🟢 | “Opus” is a single word. |
| 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_creator_ai_fullname: Opus 4.8 |
| 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 4.8” — nickname plus version, no qualifier. |
| 5.12 | The filename of the document is stated as “qrs_filename: [filename of this document]” | 🟢 | qrs_filename: tretinoin_skin_2026-0701-0003_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. | 🟢 | All values trimmed and correctly quoted. |
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 &) |
🟢 | “Tretinoin for Skin Rejuvenation - Quick Reference Sheet”; no entities needed. |
| 6.2 | [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &) |
🟢 | “Tretinoin for Skin Rejuvenation”. |
| 6.3 | [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] | 🟢 | 2026-0701-0027 → 07/01/2026. |
| 6.4 | [header_subline_model] is set to [qrs_creator_ai_fullname] | 🟢 | “Opus 4.8”. |
| 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 limited to standard subline. |
7. At-A-Glance Section
| # | Description | Result | Comments |
|---|---|---|---|
| 7.1 | [at_a_glance] is dense, execution-oriented summary of the ER Conclusion section |
🟢 | Condenses the ER Conclusion (lines 436-440). |
| 7.2 | [at_a_glance] is no longer than 60 words | 🟢 | 55 words. |
| 7.3 | Every fact in [at_a_glance] is supported by a distinct passage in the ER. | 🟢 | Each claim maps to the Conclusion. |
| 7.4 | It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead | 🟢 | “prescription vitamin A cream”; plain language. |
| 7.5 | It DOES NOT cite specific trials (names, years, sample sizes, p-values) | 🟢 | No trials cited. |
| 7.6 | It DOES NOT cite effect sizes, relative risks, or statistical results | 🟢 | No statistics. |
8. Contraindications
| # | Description | Result | Comments |
|---|---|---|---|
| 8.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | Derived from ER lines 299-301. |
| 8.2 | [stop_items] represent the Contraindications from the ER | 🟢 | Pregnancy/breastfeeding, eczema/rosacea, sunburned/broken skin, hypersensitivity, periocular/perioral margins. |
| 8.3 | Individual [stop_items] are formatted as <li></li> | 🟢 | Each item is an <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. | 🟢 | Items concise; no trailing dash clauses. |
| 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). | 🟢 | “in the treatment area” qualifier preserved; no threshold/time qualifiers dropped. |
| 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 contraindications use no ranking notation. |
| 8.7 | If no [stop_items] are present the section is left empty | N/A | stop_items are present. |
9. Key Interactions
| # | Description | Result | Comments |
|---|---|---|---|
| 9.1 | The section is derived from the ER Key Interactions & Contraindications section |
🟢 | Derived from ER lines 289-298. |
| 9.2 | [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications | 🟢 | Interactions listed; contraindications excluded. |
| 9.3 | Individual [caution_items] are formatted as <li></li> | 🟢 | Each item is an <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. | 🟢 | Severity/consequence trailing clauses stripped; concise. |
| 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). | 🟢 | Example drug lists (doxycycline, thiazides, fluoroquinolones; glycolic/lactic/salicylic; retinol/retinaldehyde/adapalene/tazarotene; laser/peels/microneedling/waxing) preserved. |
| 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 | ER interactions use no ranking notation. |
| 9.7 | If no [caution_items] are present the section is left empty | N/A | caution_items are present. |
10. Protocol
| # | Description | Result | Comments |
|---|---|---|---|
| 10.1 | The section is derived from the ER Protocol section |
🟢 | Derived from ER Therapeutic Protocol (lines 321-343). |
| 10.2 | The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section |
🟢 | Strength, Application, 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 | Three distinct aspects exist. |
| 10.4 | All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section. |
🟢 | All three action sets fully populated from ER. |
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 | 🟢 | Fine wrinkles, hyperpigmentation, surface roughness. |
| 11.2 | The sets are picked and ordered by the magnitude of the related benefit | 🟢 | All three are High-tier benefits, ordered as in the ER Benefits section. |
| 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 exist. |
| 11.4 | All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER. | 🟢 | 12–24 wk, 16–24 wk, 4–8 wk match ER (lines 165, 171, 177). |
| 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. |
12. Benefits
| # | Description | Result | Comments |
|---|---|---|---|
| 12.1 | The section is derived from the ER Expected Benefits section |
🟢 | Derived from ER Expected Benefits. |
| 12.2 | Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative] | 🟢 | All four tier spans populated. |
| 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. | 🟢 | Concise benefit phrases only. |
| 12.4 | Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | No parentheticals or effect sizes carried over. |
| 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 tiers have items. |
13. Risks
| # | Description | Result | Comments |
|---|---|---|---|
| 13.1 | The section is derived from the ER Potential Risks & Side Effects section |
🟢 | Derived from ER Potential Risks & Side Effects. |
| 13.2 | Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative] | 🟢 | All four tier spans populated. |
| 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. | 🟢 | Concise risk phrases only. |
| 13.4 | Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. | 🟢 | “(Retinoid Dermatitis)” and “(Teratogenic)” stripped. |
| 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 tiers have items. |
14. Monitoring
| # | Description | Result | Comments |
|---|---|---|---|
| 14.1 | The section is derived from the ER Monitoring section |
🟢 | Derived from ER Monitoring Protocol (lines 404-408). |
| 14.2 | All measurable/quantifiable biomarkers from the Monitoring section are listed |
🟢 | Serum retinol and pregnancy test (β-hCG) listed; the third row (skin barrier/hydration) is explicitly clinical, not a lab biomarker. |
| 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. |
🟢 | Cadence populated (2–4 wk, 8–12 wk, 3–6 mo, then 6–12 mo). |
15. Qualitative Assessment
| # | Description | Result | Comments |
|---|---|---|---|
| 15.1 | The section is derived from the ER Monitoring section |
🟢 | Derived from ER qualitative markers (lines 412-416). |
| 15.2 | All subjective/qualitative biomarkers from the Monitoring section are listed |
🟢 | All five qualitative markers listed. |
Issues 01/07/2026 00:47
Pass rate 100.00%. No issues found.
Issues 01/07/2026 00:42
- 15.2 — Clinical marker listed as qualitative: qualitative_item_6 “Skin barrier / hydration: no visible cracking, minimal scaling” reproduces the ER monitoring-table clinical row (ER line 408), which is not among the ER’s five subjective/qualitative success markers (ER lines 412-416).
Fixes 01/07/2026 00:42
- 15.2 — Removed non-qualitative marker: Deleted qualitative_item_6 (“Skin barrier / hydration: no visible cracking, minimal scaling”), a clinical monitoring-table row, so the Qualitative Assessment now lists only the ER’s five subjective success markers.
Issues 01/07/2026 00:36
- 11.2 — Time-to-effect order mismatch: All three time-to-effect items are High-tier benefits, but the ER orders them fine wrinkles → mottled hyperpigmentation → surface roughness (lines 161–177); the QRS places surface roughness (line 493) before hyperpigmentation (line 503), reversing the benefit-magnitude order.
Fixes 01/07/2026 00:36
- 11.2 — Time-to-effect order fixed: Reordered the time-to-effect cells to follow the ER’s High-benefit magnitude order, swapping surface roughness (4–8 weeks) and hyperpigmentation (16–24 weeks) so the sequence is now fine wrinkles → hyperpigmentation → surface roughness.
Issues 01/07/2026 00:31
- 13.3 — Explanatory parentheticals in risks: risks_high (line 572: “Skin irritation (retinoid dermatitis); photosensitivity (increased sun sensitivity)”) and risks_low (line 578: “Theoretical reproductive (teratogenic) concern”) retain clarifying parenthetical explanations rather than being reduced to the key fact only; the parallel Benefits section was stripped clean of such parentheticals.
Fixes 01/07/2026 00:31
- 13.3 — Stripped explanatory parentheticals in risks: Removed clarifying parentheticals so only the key fact remains — risks_high “Skin irritation (retinoid dermatitis); photosensitivity (increased sun sensitivity)” → “Skin irritation; photosensitivity”, and risks_low “Theoretical reproductive (teratogenic) concern” → “Theoretical reproductive concern”.