This topic covers the operation of the adjudication tools for a person with the Adjudication Lab Personnel role. Anyone with that role may perform the tasks described here, though it is good practice to designate a single person as the primary "monitor" of alerts and case progress.
The dashboard, case summary statistics, and role-specific UI notifications are also visible to the Folder Admin, Infection Monitors, and Data Reviewers.Adjudication lab personnel initiate an adjudication case when they determine one is necessary. Case data is uploaded and submitted to the adjudicators. Information about both active and completed cases is available on the dashboard. Once an agreed diagnosis is reached in a case, lab personnel verify the determination.
When cases are active in the folder, the dashboard web part offers the ability to view current status of active and completed cases at a glance.
Particularly in HIV diagnosis, it is critical that action is taken when a positive diagnosis is reached. When the adjudication tools are configured to diagnose both HIV-1 and HIV-2 strains, notifications that an infection has been detected are raised independently for each strain.
In a case where there is agreement on only one strain, the status "Infection detected, resolution required" is shown on the dashboard. Hover text indicates which determinations matched, allowing quick patient followup when necessary, even while the overall case remains active.
Displays a summary of active/completed cases and how long cases have been taking to complete to assist lab personnel in planning and improving process efficiency.
SELECT count(adj.CaseId) AS TotalCases,
sum(CASE WHEN adj.StatusId.Status = 'Active Adjudication' THEN 1 ELSE 0 END) AS ActiveCases,
sum(CASE WHEN adj.StatusId.Status = 'Complete' THEN 1 ELSE 0 END) AS CompleteCases,
round(avg(TIMESTAMPDIFF('SQL_TSI_DAY', adj.Created, adj.Completed)),2) AS AveCompDays,
min(TIMESTAMPDIFF('SQL_TSI_DAY', adj.Created, adj.Completed)) AS MinCompDays,
max(TIMESTAMPDIFF('SQL_TSI_DAY', adj.Created, adj.Completed)) AS MaxCompDays,
round(avg(TIMESTAMPDIFF('SQL_TSI_DAY', adj.Completed, adj.LabVerified)),2) AS AveReceiptDays,
min(TIMESTAMPDIFF('SQL_TSI_DAY', adj.Completed, adj.LabVerified)) AS MinReceiptDays,
max(TIMESTAMPDIFF('SQL_TSI_DAY', adj.Completed, adj.LabVerified)) AS MaxReceiptDays
FROM AdjudicationCase adj
LEFT JOIN Status ON Status.RowId = adj.StatusId
The Notifications web part displays active alerts that require the attention of the particular user viewing the web part. The user can click to dismiss the UI notification when action has been taken. If there are no UI notifications pending for this user, the web part will not be displayed. Each UI notification has a link to View details, and another to Dismiss the message from the web part.
The adjudication tools also send email notification messages to subscribed individuals, including lab personnel, data reviewers, infection monitors, and others identified as "to be notified." The email includes a direct link to the adjudication review page for the case.
Whether emails are sent, UI notifications are displayed, or both is governed by assigned roles.
For each type of UI notification, the rules for when it is added and dismissed vary somewhat.
| Notification Type | Lab Personnel | Adjudicators | Folder Admin | Infection Monitor | Data Reviewer | "To Be Notified" users |
|---|---|---|---|---|---|---|
| Case Created | yes | yes | yes | no | no | no |
| Case Assay Data Updated | yes | yes | yes | no | no | no |
| Case Completed | no | no | yes | yes - if infection present | no | no |
| Case Ready for Verification | yes | no | no | no | no | no |
| Case Resolution Required | no | yes | no | no | no | no |
| Case Infection Detected | yes | yes | yes | yes | no | no |
This table shows which roles receive email notifications for each type:
| Notification Type | Lab Personnel | AdjudicatorsA | Folder Admin | Infection Monitor | Data Reviewer | "To Be Notified" users |
|---|---|---|---|---|---|---|
| Case Created | yes | yes | yes | no | yes | yes |
| Case Assay Data Updated | yes | yes | yes | no | yes | yes |
| Case Completed | yes | yes | yes | no | no | yes |
| Case Determination Updated | yes | no | yes | yes - if infection present | yes | yes |
| Case Resolution Required | no | yesB | no | no | no | no |
| Case Infection DetectedC | yes | yes | yes | yes | no | yes |
Notes:
A. Email notifications for adjudicators can be enabled or disabled by the adjudication administrator.
B. The "Case Resolution Required" email is sent to all adjudicators in one email with multiple addresses on the To: line.
C. The "Infection Detected" email notification is sent while the case is not completed in order to allow prompt follow-up on the agreed diagnosis, while a process outside these tools is required to resolve the disagreement on diagnosis of the other strain.
When all adjudicators have made determinations and are in agreement, a notification goes to the lab personnel. The final step in the process is for them to verify the determination.
When an update to a case is required, perhaps because additional assay data is provided in response to any adjudicator indicating additional testing is required, a member of Lab Personnel can reupload the case. When re-uploading, the case filename is case-insensitive (i.e. vtn703_123456782_01Aug2015.txt will be an update for VTN703_123456782_01Aug2015.txt).
Any time a case has multiple uploads for the same date, the user will be prompted whether to merge (append) the new data, or replace the existing data and create a new case.
When you upload additional data, all assigned adjudicators will receive notification that there is new data to review.
Case data can also be updated by lab personnel after the case determination is made. When that happens, the case data is flagged with an explanatory message "Note: This data was added after the adjudication determination was made." Note, however, that the case remains closed. If the new information might change previous diagnostic decisions, a new case should be opened to obtain a new adjudicated diagnosis.
On the Manage page, under Adjudication Email Reminders, click Cases.
You will see a Send Email Reminder button for each case without completed determination. Click to send email to all assigned adjudicator team members for that case.
Automatic daily email reminders can be configured at the site, project, or folder level using the module property, "Automatic Reminders". Daily reminders will be sent when other system maintenance tasks are performed.
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