Audit: QRS - Video Gaming to Improve Cognitive Ability

Audit conducted on 17/09/2026 13:28 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

---

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.	🟢	Protocol cells, time-to-effect cells, benefit/risk tiers, all 14 monitoring markers and all 7 qualitative items trace to ER Therapeutic Protocol, Practical Considerations, Expected Benefits, Potential Risks & Side Effects and Monitoring Protocol & Defining Success.
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 divided-evidence framing is carried into the lede (“smaller and contested in younger adults”, “Summaries of the same studies disagree”).
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”).	🟢	Contraindication wording preserves the ER’s absolutes (“until cleared by a neurologist”, “until symptoms resolve”); no tier or severity shifted.
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.	🟢	Gates come only from Key Interactions & Contraindications; benefits/risks only from their own ER sections; no Benefit-Modifying Factors or Risk-Modifying Factors content migrated.
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.	🟢	The QRS carries no PMIDs, author names, NCT IDs or brand names at all.
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.	🟢	Neutral, evidence-weighted register matching the ER, including its explicit acknowledgement of conflicting meta-analyses.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Quantified targets and doses alongside plain-language framing.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Statements are descriptive (“Most positive trials ran 4-12 weeks”), not directives.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No imperative instructions; gates are stated as conditions, not orders.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	Reported rather than prescribed throughout, including the passive “protocols beyond 30 hours are urged”.
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	🟢	Technical terms retained are load-bearing decision criteria (e.g., photoparoxysmal response, Berg Balance Scale); no gratuitous jargon.
2.8	Information is presented in a concise and very compact manner	🟢	Gate and tier items are stripped to the key fact; monitoring rows drop the ER’s Context/Notes column.
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.	🟢	Content assumes self-testing with a validated cognitive battery, UFOV threshold and wearable sleep data.
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.	🟢	20-50 hours of structured play plus a 14-marker monitoring panel presuppose high commitment.
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.	🟢	Depth of the monitoring and gate content is well beyond general-population material.
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.	🟢	Displacement of physical activity and the over-60 concentration of benefit are surfaced, matching the ER’s audience-specific weighting.
2.14	The document’s own voice frames usage in longevity terms, not “anti-aging” (e.g., “anti-aging clinics”, “anti-aging community”, “anti-aging medicine”). Proper names that contain “anti-aging” (e.g., “American Academy of Anti-Aging Medicine”) are quoted verbatim.	🟢	No occurrence of “anti-aging” in the document.
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.	🟢	Formal register maintained (“Prescription stimulants”, “Sedative-hypnotics”, “Over-the-counter medications”, “orthostatic hypotension”).

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 strings byte-identical to [qrs_template].
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 34 template variable names present; the repeatable marker_#_* and qualitative_item_# rows are instantiated as marker_1-14 and qualitative_item_1-7.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	A structural diff against the template shows differences only inside data-qrs-var spans and in the repeated monitoring/qualitative rows.

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 that feeds 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.	🟢	Protocol labels (“Genre selection drives the outcome”, “Standard research dose”, “Adaptive difficulty is the active ingredient”) and all nine Key Interactions labels are verbatim ER bold labels; monitoring row labels are verbatim ER table names.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Time-to-effect labels use verbatim ER phrases (“untrained attention and speed tasks”, “persistence of gains”, “Near-transfer to the game”) from the single Time to effect bullet.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji present; the ER’s ⚠️/⭕️ markers were stripped.
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 the minimum the checklist allows — gate items reduced to the key fact, benefit/risk tiers collapsed to semicolon lists, monitoring reduced to three columns.

---

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, immediately after <!doctype html>.
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 line 3, closing --- at 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 duplicate on-page rendering.
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: "00:03" is quoted, correctly so because it contains a colon.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	er_filename: video_gaming_cognitive_2026-0917-1035_Opus_ER.md (line 4).
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: 26.9.11 matches 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)	🟢	qrs_creation_date: 2026-0917-1322.
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)	🟢	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_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_filename: video_gaming_cognitive_2026-0917-1035_Opus_QRS.html matches 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 twelve keys.

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 &)	🟢	“Video Gaming to Improve Cognitive Ability - Quick Reference Sheet” (line 22); no entity encoding required.
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	“Video Gaming to Improve Cognitive Ability” (line 417).
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	2026-0917-1322 → “09/17/2026” (line 421).
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	“Opus 5” (line 425).
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 matches the template exactly; no extra elements.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Compresses the ER Conclusion’s three paragraphs: which abilities move, in whom, the exergame qualifier, and the divided evidence base.
7.2	[at_a_glance] is no longer than 60 words	🟢	58 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Each clause maps to a distinct sentence in the ER Conclusion (lines 519-521).
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	“holding information in mind”, “switching between tasks”, “games that add movement to mental challenge” — no acronyms or clinical-register terms.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial identifiers of any kind.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No numeric results; only the qualitative “modest”/”largest”/”smaller”.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All six items come from the ER’s “Populations who should avoid Video Gaming” list (lines 344-349).
8.2	[stop_items] represent the Contraindications from the ER	🟢	Six ER bullets → six QRS items, one-to-one, no additions or omissions.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Six <li> elements inside the 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.	🟢	Trailing rationale stripped, e.g. the ER’s “for whom sustained near work is restricted” is dropped from the ocular-surgery item.
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).	🟢	“(Berg Balance Scale below 45)”, “Within 90 days”, “a fall in the preceding 3 months”, “unless supervised” and “until cleared by a neurologist” all retained.
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 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 six such populations and the section is correctly populated.
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 come from the ER’s interaction bullets (lines 324-340).
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	Nine ER interaction bullets → nine QRS items; the Parkinson’s/impulse-control contraindication is a narrower population and is not duplicated here.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Nine <li> elements inside the span.
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/Mitigation clauses stripped; only label plus named agents remain.
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 agents preserved for every class (methylphenidate, lisdexamfetamine; pramipexole, ropinirole; zolpidem, zopiclone, temazepam; valproate, levetiracetam, lamotrigine; and the supplement and co-intervention lists).
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 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 interactions and the section is correctly populated.
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 ER Therapeutic Protocol lines 377-381.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Genre selection, dose (session length / frequency / total hours), and adaptive difficulty — the ER’s three lead bullets and the only ones that determine execution.
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 well over three actionable aspects; 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.	🟢	Nine of nine spans populated with ER-traceable content; no placeholders remain.

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	🟢	Untrained attention/speed transfer (10-20 hours), persistence of gains (6 months), near-transfer to the game (within hours).
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Leads with the High-tier attention and processing-speed transfer, then durability of that gain, then game-specific near-transfer, which maps to no benefit tier.
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 supplies three distinct aspects; 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.	🟢	Nine of nine spans populated from ER Practical Considerations line 438, Therapeutic Protocol line 395 and Discontinuation & Cycling line 416.
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 an explicit “Time to effect” bullet.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	All nine benefit headings from ER lines 148-206 are represented.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present and populated in tier order.
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 tier is a semicolon-separated list of the ER’s benefit headings only; no Hedges’ g, SMD or CI values carried over.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	The ER’s “⚠️ Conflicted” markers and all magnitude paragraphs are stripped.
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 in the ER.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	All eleven risk headings from ER lines 232-302 are represented.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present and populated in tier order.
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.	🟢	Tiers are semicolon-separated heading lists; no prevalence figures, odds ratios or confidence intervals carried over.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	The “⚠️ Conflicted” and “⭕️ Not Central” markers on the aggression and depression items are 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 in the ER.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Rows mirror the ER Monitoring Protocol & Defining Success biomarker table (lines 472-487).
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All 14 ER rows present in ER order, from the cognitive battery composite through photic-stimulation EEG, with targets and rationales preserved.
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.	🟢	Baseline, 4 weeks, 12 weeks, every 6 months, with the per-marker exceptions — matching ER line 470.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	Drawn from the ER’s qualitative-markers list (lines 491-497).
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All seven ER qualitative markers present, verbatim and in ER order.

Issues 17/09/2026 13:28

Pass rate 100.00%. No issues found.