Audit: QRS - NanoKnife to Treat Prostate Cancer

Audit conducted on 25/06/2026 14:37 using AI4L / Opus 4.8

Iterations

Summary

Items	Count
Total	91
Passed	90
Failed	0
N/A	1
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 cells trace to ER content (protocol, benefits, risks, monitoring, conclusion).
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.	🟢	“Long-term durability remains uncertain” / “some cancer persists or returns” mirror ER cautious framing.
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 or softening detected.
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 are drawn from the ER’s own contraindication/interaction bullets.
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, NCT IDs, or expert names introduced in the QRS.
1.6	The QRS does not introduce new attributions.	🟢	No new 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.	🟢	Tone matches the measured, evidence-driven ER.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Balanced expert-yet-accessible voice maintained.
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-giving language.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	Information-presenting 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 with brief expansions where needed.
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 “you”/”your”.
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 the proactive, risk-aware 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.	🟢	Selection/follow-up framing assumes a committed audience.
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 written 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.	🟢	Weighting reflects the proactive 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.	🟢	No “anti-aging” language used.
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; plain expansions are appropriate.

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/labels match the template verbatim.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All template spans present; repeatable marker/qualitative rows correctly instantiated.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	No unaddressed spans modified.

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”	🟢	No source sections were empty; all populated cells map to ER content.
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.	🟢	Gate and monitoring labels derive faithfully from ER labels.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Labels reflect ER content without invention.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji indicators present.
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 the first element after the doctype.
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 “—” 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.	🟢	Enclosed in an 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; only duration is quoted (contains colon).
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	er_filename: nanoknife_prostate_2026-0625-1329_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: 2026-0625-1329
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 “Opus”.
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: nanoknife_prostate_2026-0625-1329_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.	🟢	Values trimmed and consistent.

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 &)	🟢	“NanoKnife to Treat Prostate Cancer - Quick Reference Sheet”; no entities required.
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	“NanoKnife to Treat Prostate Cancer”.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	“06/25/2026” from 2026-0625.
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 carries only date, source-ER link, AI4L link, and model.

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 faithfully.
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 Conclusion passage.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	“urine-control muscle”, “continence”, “erections” — 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 cited.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	Drawn from the ER’s “Populations who should avoid” bullet.
8.2	[stop_items] represent the Contraindications from the ER	🟢	All 7 contraindications captured.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Each item is its own <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 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).	🟢	Staging, grade, volume, PSA, platelet, and ASA qualifiers 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.	🟢	Threshold symbols are self-contained; no bare ranking symbols carried.
8.7	If no [stop_items] are present the section is left empty	🟢	Contraindications present and populated.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	Drawn from the ER interaction bullets.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	5 interactions, none overlapping contraindications.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Each item is its own <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; no trailing dash clauses.
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/supplement lists preserved in parentheses.
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.	🟢	Parentheticals are plain comma-separated drug lists.
9.7	If no [caution_items] are present the section is left empty	🟢	Key Interactions present and populated.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	Action cells map to the ER Therapeutic Protocol.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	Procedure, setting/delivery, and eligibility/selection covered.
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.	🟢	All three sets populated; none placeholdered.
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section.	🟢	Labels, values, and subs all derive 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	🟢	Ablation, PSA response, confirmed success covered.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Ordered immediate → PSA nadir → biopsy confirmation.
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.	🟢	Three sets populated.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢	Values/subs map to ER Practical Considerations.
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 information; section retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	Tiers map to ER Expected Benefits.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four tier variables 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.	🟢	Bare benefit phrases only.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	“(Abscopal)” and magnitudes 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.	🟢	All tiers have ER content; no empty-state phrasing.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	Tiers map to ER Potential Risks & Side Effects.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four tier variables 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.	🟢	Bare risk phrases only.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	“(Including Rectourethral Fistula)” and “(Standard IRE)” 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.	🟢	All tiers have ER content; no empty-state phrasing.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Markers map to the ER Monitoring Protocol table.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	PSA, PSA density, mpMRI findings, surveillance biopsy all listed.
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 (3/6/12 months; MRI year 1; biopsy 6–18 months) populated.

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.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	Urinary, erectile, recovery/energy, psychological all listed.

Issues 25/06/2026 14:37

Pass rate 100.00%. No issues found.

Issues 25/06/2026 14:30

1. 12.4 — Parenthetical not stripped in benefits: benefits_speculative (QRS line 531) retains the parenthetical “(abscopal)” in “Immune-mediated (abscopal) anti-tumor effect”; per 12.4 parenthetical content must be stripped.
2. 13.4 — Parenthetical not stripped in risks: risks_low (QRS line 575) retains the parenthetical “(including rectourethral fistula)” in “Serious procedural complications (including rectourethral fistula)”; per 13.4 parenthetical content must be stripped.

Fixes 25/06/2026 14:30

1. 12.4 — Strip parenthetical in benefits: Removed “(abscopal)” from benefits_speculative; “Immune-mediated (abscopal) anti-tumor effect” → “Immune-mediated anti-tumor effect”.
2. 13.4 — Strip parenthetical in risks: Removed “(including rectourethral fistula)” from risks_low; “Serious procedural complications (including rectourethral fistula); general anesthesia and muscle-contraction effects” → “Serious procedural complications; general anesthesia and muscle-contraction effects”.