Adjudication is a workflow process in which two (or more) independent people (or teams) make a determination about diagnoses given certain data and criteria. Each team of adjudicators has access to the same data, but can not see the determinations made by others adjudicators until all determinations are complete.

This topic outlines the procedure followed by a person assigned the role of Adjudication Lab Personnel in the adjudication process. For context, you can review the overall process documentation here.

Role Description

Adjudication Lab Personnel are the individuals who upload case details, monitor their progress through adjudication, and report final diagnosis determinations back to the lab when the process is complete. The role is granted by the adjudication folder administrator.

The format of case data, and types of assay data that may be included, are prescribed within the folder by an administrator. Cases are assigned to and receive diagnosis determinations from 2-5 adjudicator teams, each consisting of one person, plus a backup person in case they are unavailable. Determinations made by each adjudicator (team) are blinded to the lab personnel and other teams until all determinations have been recorded.

If any adjudicator requests additional testing or other information, lab personnel are notified so that the additional data can be acquired and the case updated.

When all adjudication decisions are entered, lab personnel will be notified. If determinations differ, the adjudicators will need to meet to decide whether to request additional testing or one or more may decide to change their determinations so that they are in agreement. Once all determinations are entered and agree on a diagnosis, lab personnel will report the result back to the lab.

Task List

There may be one or many adjudication lab personnel working with a given adjudication folder. All users granted this role may equally perform all of the steps in the progress of a case through the process; coordination outside the tools is advised to avoid duplication of effort if many people are working together.

  • Upload Adjudication Case Data
  • Monitor Case Progress
  • Update Case Data (if necessary)
  • Report Diagnosis to Lab

Upload Adjudication Case Data

The format and filename of the uploaded case data file are determined by settings configured by the folder administrator. Only assay kits explicitly enabled within the folder can be included. Only columns included in the assay results table will be stored. If you need additional kits enabled or columns added to the assay results table in your folder, contact the administrator.

If any of the adjudication teams are empty at the time of upload, you may still proceed, but the administrator must assign adjudicators before the case can be completed. For a more detailed walkthrough of the upload process, see Initiate an Adjudication Case.

  • Log in to the adjudication folder and click the Upload tab.
  • Step 1: Upload Adjudication Data File: click Browse and select the adjudication data file.
    • The number of rows of data imported will be displayed.
    • If the case requires evaluation of data from multiple dates, all data will be included in the same case, separated by visit.
    • If the case has multiple uploads for the same date, the user will be prompted whether to replace the existing data, append the new data, or create a new case.
    • Click Next.
  • Step 2: Adjudication Case Creation: Prior to this step, the folder administrator must have assigned adjudicators to teams. If any remain empty, you will see a warning, but can still proceed with case creation.
    • Enter a case comment as appropriate.
    • Click Next.
  • Step 3: Upload Additional Information: click insert to add information to the case if necessary.
    • Click Next.
  • Step 4: Summary of Case Details: Confirm accuracy and click Finish.

When you have uploaded a case, the adjudication process is initiated and notifications of your new case upload are sent to all assigned adjudicators. The uploaded case data file is stored in the caseDocuments table on the server for later retrieval if necessary.

Monitor Case Progress

After uploading at least one case, you will be able to review case status on the Administrator Dashboard tab.

This screencap shows 4 notifications to view or dismiss, the dashboard showing active and completed cases, and a case summary report in the upper right which tracks the time it takes to complete cases and return results to the lab. For more information about each web part, see Monitor Adjudication.

As adjudicators enter determinations, you can see progress toward case completion. In the screencap, case 48 is awaiting the last determination. If you click the Details link for the case, you can scroll to the bottom to see who is assigned to the team that still needs to make a determination.

Update Case Data

If any adjudicator indicates that additional testing is required, you will need to obtain those new results and update the case in question. If the case has multiple uploads for the same date, the user will be prompted whether to replace the existing data, append the new data, or create a new case. When re-uploading a case, the case filename is case-insensitive (i.e. vtn703_123456782_01Aug2015.txt will be an update for VTN703_123456782_01Aug2015.txt).

When you upload additional data, all assigned adjudicators will receive notification that there is new data to review.

Report Diagnosis to Lab

After all adjudicators have agreed on a diagnosis, your final task for that case is to record the result in the lab. In the screencap above, case 50 is completed, but no decision has been recorded yet. Click the Details link for the case, scroll to review the diagnosis determinations, and click Verify Receipt of Determination to close the case and clear the notification.

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