Audit: QRS - Tadalafil for Health & Longevity

Audit conducted on 02/07/2026 12:35 using AI4L / Opus 4.8

Iterations

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 content traces to the ER (Conclusion, Expected Benefits, Risks, Key Interactions & Contraindications, Protocol, 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. 🟢 At-a-glance mirrors the ER’s observational caution (“studies that cannot prove cause”); speculative tiers preserved.
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; observational and speculative caveats retained via tiering and wording.
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/Interactions drawn from the ER’s own Key Interactions & Contraindications section; no cross-category relabeling.
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 IDs, or expert names introduced; brand context absent from the QRS.
1.6 The QRS does not introduce new attributions. 🟢 No new attributions added.

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-graded 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 🟢 Expert yet accessible framing throughout.
2.3 The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor 🟢 Presents evidence, not prescriptions.
2.4 The QRS avoids language that implies medical or clinical advice 🟢 No directive/advisory phrasing; footer disclaimer present.
2.5 The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising” 🟢 Content is descriptive 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 phrasing (e.g., “enlarged-prostate urinary symptoms”).
2.8 Information is presented in a concise and very compact manner 🟢 Compact cells and bulleted tiers.
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 proactive longevity-oriented 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. 🟢 Daily protocol and monitoring cadence presented without dilution.
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 pitched to a passive general 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. 🟢 Longevity-oriented low-dose daily framing surfaced.
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” usage; title uses “Health & Longevity”.
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. 🟢 Uses “oral medication”, “vasodilatory effects”, etc.

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 present and unmodified.
3.2 All “” from the [qrs_template] are present in the the QRS. 🟢 All template spans present (marker_# and qualitative_item_# expanded to numbered instances).
3.3 Spans that are not addressed in a checklist item are left unchanged 🟢 Non-content template spans (e.g., website markers) left intact.

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 QRS section is empty; all tiers and cells are populated.
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. 🟢 Monitoring row markers (Blood pressure, HbA1c, eGFR, ALT/AST, IPSS) match the ER table verbatim.
4.3 Labels are not paraphrased, abbreviated, or invented. 🟢 Labels preserved from the 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; ER’s “⚠️ Conflicted” and tier emoji dropped.
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 single-page card layout.

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 the 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. 🟢 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 “00:00” (contains colon) is quoted.
5.5 The filename of the source ER is stated as “er_filename: [er_filename]” 🟢 er_filename: tadalafil_2026-0702-1047_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: 2026-0702-1047.
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: tadalafil_2026-0702-1047_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 clean 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., &amp; for &) 🟢 “Tadalafil for Health & Longevity - Quick Reference Sheet”.
6.2 [header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., &amp; for &) 🟢 “Tadalafil for Health & Longevity”.
6.3 [header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY] 🟢 “07/02/2026” from 2026-0702.
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 title and 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 452–454).
7.2 [at_a_glance] is no longer than 60 words 🟢 54 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 🟢 Plain-language throughout; no acronyms.
7.5 It DOES NOT cite specific trials (names, years, sample sizes, p-values) 🟢 No trial citations.
7.6 It DOES NOT cite effect sizes, relative risks, or statistical results 🟢 No effect sizes or statistics.

8. Contraindications

# Description Result Comments
8.1 The section is derived from the ER Key Interactions & Contraindications section 🟢 Drawn from the ER Key Interactions & Contraindications section (lines 295–313).
8.2 [stop_items] represent the Contraindications from the ER 🟢 Nitrates, riociguat, and the ER’s “avoid / specialist care” population list mapped.
8.3 Individual [stop_items] are formatted as <li></li> 🟢 Nine <li> items.
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 mechanism/mitigation clauses stripped.
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). 🟢 “<90 days”, “resting BP <90/50 mmHg”, “NYHA Class III–IV”, “Child-Pugh Class C” 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. N/A The ER contraindication list uses no “>” ranking notation.
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 the ER section (lines 295–313).
9.2 [caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications 🟢 Nitrates/riociguat correctly excluded; alpha-blockers, antihypertensives, CYP3A4 inhibitors/inducers, supplements, alcohol included.
9.3 Individual [caution_items] are formatted as <li></li> 🟢 Six <li> items.
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.
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 preserved (e.g., “doxazosin, terazosin, tamsulosin, silodosin”).
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 interaction list uses no “>” ranking notation.
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 🟢 Drawn from the ER Therapeutic Protocol section (lines 333–355).
10.2 The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section 🟢 Dose, Timing, Regimen — the core actionable aspects.
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 cells populated from the ER Protocol.

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 🟢 Erectile function, urinary symptoms, vascular changes.
11.2 The sets are picked and ordered by the magnitude of the related benefit 🟢 High-tier benefits (erectile, urinary) precede Medium-tier vascular.
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 time-to-effect aspects are present.
11.4 All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER. 🟢 All three cells populated from the 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 The ER provides time-to-effect information (line 386).

12. Benefits

# Description Result Comments
12.1 The section is derived from the ER Expected Benefits section 🟢 Drawn from the ER Expected Benefits section (lines 149–205).
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 statements only.
12.4 Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 “(Observational)” and “⚠️ Conflicted” dropped from headings.
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 contain items.

13. Risks

# Description Result Comments
13.1 The section is derived from the ER Potential Risks & Side Effects section 🟢 Drawn from the ER Potential Risks & Side Effects section (lines 223–279).
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 statements only.
13.4 Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved. 🟢 “(Myalgia)” and “(Prolonged Erection)” 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. N/A All four tiers contain items.

14. Monitoring

# Description Result Comments
14.1 The section is derived from the ER Monitoring section 🟢 Drawn from the ER Monitoring Protocol & Defining Success section (lines 408–430).
14.2 All measurable/quantifiable biomarkers from the Monitoring section are listed 🟢 All five biomarkers (Blood pressure, HbA1c, eGFR, ALT/AST, IPSS) 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 populated (2–4 weeks, then every 6–12 months, etc.).

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 424–430).
15.2 All subjective/qualitative biomarkers from the Monitoring section are listed 🟢 All five qualitative markers listed.

Issues 02/07/2026 12:35

Pass rate 100.00%. No issues found.

Issues 02/07/2026 12:31

  1. 12.4 — Parenthetical not stripped in benefits: [benefits_medium] (line 525) keeps the qualifier “(observational)” in “lower cardiovascular events and mortality (observational)”; per 12.4 parenthetical content must be stripped.
  2. 13.4 — Parenthetical not stripped in risks: [risks_low] (line 582) keeps the gloss “(prolonged erection)” in “priapism (prolonged erection)”; per 13.4 parenthetical content must be stripped.

Fixes 02/07/2026 12:31

  1. 12.4 — Strip observational parenthetical: Removed the qualifier “(observational)” from [benefits_medium], changing “lower cardiovascular events and mortality (observational)” to “lower cardiovascular events and mortality”.
  2. 13.4 — Strip priapism gloss: Removed the parenthetical gloss “(prolonged erection)” from [risks_low], changing “priapism (prolonged erection)” to “priapism”.