Audit: QRS - Lithium for Health & Longevity

Audit conducted on 02/07/2026 14:00 using AI4L / Opus 4.8

Iterations

Summary

Items	Count
Total	91
Passed	84
Failed	0
N/A	7
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.	🟢	All content traces to the ER (benefits/risks tiers, protocol, monitoring, contraindications, interactions).
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.	🟢	At-a-glance “promising but unproven” mirrors ER Conclusion “promising but not settled”.
1.3	The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”).	🟢	No strengthening/softening; pregnancy kept as a contraindication.
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.	🟢	Categories preserved; contraindications and interactions drawn from the correct ER 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, or expert names introduced 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-forward tone matches the ER.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Balanced expert/accessible tone throughout.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Presents information without prescribing.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No advice language; footer disclaimer present.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	Presents facts and protocol content only.
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 with necessary terms only.
2.8	Information is presented in a concise and very compact manner	🟢	Compact cells and bullets.
2.9	It DOES NOT address the reader directly	🟢	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 targets risk-aware longevity adults.
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.	🟢	Protocol and monitoring assume willingness to follow effortful steps.
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.	🟢	Not framed for the general population.
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.	🟢	Low-dose longevity framing consistent with 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.	🟢	Uses “longevity”/”aging brain”; no “anti-aging” framing.
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; plain-language at-a-glance permitted by 7.4.

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 and labels present and unmodified.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	Full set of 58 spans present.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	No unrelated spans altered.

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 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/monitoring labels align with ER labels.
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 the 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 fit one page.

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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.	🟢	Metadata comment is first element after doctype (lines 2-14).
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 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.	🟢	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 trimmed; duration quoted appropriately.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	er_filename: lithium_2026-0702-1227_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: 26.7.02 (line 5).
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: 2026-0702-1348 (line 6).
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 (line 7).
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.
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 (line 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” with no extra qualifier.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	qrs_filename: lithium_2026-0702-1227_Opus_QRS.html (line 9).
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.	🟢	Values clean; duration quoted for colon.

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 &)	🟢	“Lithium for Health & Longevity - Quick Reference Sheet” (line 22).
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	“Lithium for Health & Longevity” (line 417).
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	07/02/2026 from 2026-0702 (line 421).
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	“Opus 4.8” (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.	🟢	Only date + AI4L / Opus 4.8; no extra content.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Distilled from the ER Conclusion (lines 454-456).
7.2	[at_a_glance] is no longer than 60 words	🟢	56 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Water-lithium/dementia/mortality, GSK-3 enzyme, thyroid/kidney checks all traceable.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	Plain language; “brain-aging enzyme” instead of GSK-3.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial names or years.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No statistics cited.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	Drawn from ER “Populations who should avoid lithium” (line 321).
8.2	[stop_items] represent the Contraindications from the ER	🟢	All five avoid-populations represented.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Each item is a separate <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.	🟢	Concise; no trailing explanatory 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).	🟢	eGFR threshold “(eGFR persistently below ~45 mL/min/1.73 m²)” 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.	🟢	No bare ranking symbols carried through.
8.7	If no [stop_items] are present the section is left empty	N/A	Contraindications are present.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	Drawn from ER interactions bullets (lines 307-319).
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	Seven interactions listed; no overlap with contraindications.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Each interaction is a separate <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.	🟢	Concise interaction names with example drugs only.
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 (e.g., hydrochlorothiazide, ibuprofen, lisinopril) 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.	🟢	No bare ranking symbols carried through.
9.7	If no [caution_items] are present the section is left empty	N/A	Key Interactions are present.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	Derived from ER Therapeutic Protocol / Risk Mitigation.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Form & Dose, Timing, Baseline Labs.
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 actionable aspects are present.
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 filled from the 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	🟢	ER provides two distinct time-to-effect aspects; both captured (time_1, time_2), third left empty per 11.3.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Cognitive & Mood Effects ordered before Steady-State Levels.
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.	🟢	Only two aspects exist; time_3 set is empty and display:none.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢	Both used sets filled (Months; Days to a couple of weeks).
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.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	Benefits mirror ER Expected Benefits tiers.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four benefit tiers 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 names only.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parenthetical 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 benefit tiers have items.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	Risks mirror ER Potential Risks tiers.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four risk tiers 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 names only.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No frequencies or parentheticals carried over.
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 have items.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Table derived from ER Monitoring Protocol biomarker table.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All six ER markers listed (eGFR, creatinine, TSH, Free T4, serum lithium, calcium).
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, then at around 3 months, then every 6–12 months” (ER line 414).

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	Derived from ER qualitative markers (lines 427-432).
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All six qualitative markers listed.

Issues 02/07/2026 14:00

Pass rate 100.00%. No issues found.

Issues 02/07/2026 13:56

1. 11.1 — Only two time-to-effect sets: The Time to Effect area populates only two sets (Cognitive & Mood Effects, Steady-State Levels; lines 483–500); the third set (time_3, line 503) is empty and hidden. The ER supplies only two distinct time-to-effect aspects, but the item requires three sets to be covered.

Fixes 02/07/2026 13:56

1. 11.1 — Only two time-to-effect sets: Reviewed the ER for a third distinct time-to-effect aspect; the ER supports only two (cognitive/mood effects over months; steady-state levels over days to a couple of weeks). Adding a third set would require content not literally supported by the ER (violating item 1.1), so the two ER-supported sets were retained and the unused third set left empty and hidden per item 11.3. No fabricated content added.

Issues 02/07/2026 13:52

1. 12.4 — Parenthetical not stripped in benefits: [benefits_low] (line 528) retains “(cross-species signal)” carried over from the ER benefit heading “Lifespan Extension (Cross-Species Signal)”; parenthetical content must be stripped.
2. 13.4 — Parenthetical not stripped in risks: [risks_high] (line 573) retains “(hypothyroidism)” and [risks_speculative] (line 582) retains “(pregnancy risk)”, carried over from the ER risk headings; parenthetical content must be stripped.

Fixes 02/07/2026 13:52

1. 12.4 — Stripped benefits parenthetical: Removed “(cross-species signal)” from [benefits_low], leaving “Lifespan extension”.
2. 13.4 — Stripped risks parentheticals: Removed “(hypothyroidism)” from [risks_high] and “(pregnancy risk)” from [risks_speculative].