Help & Documentation

Grading Images

This guide explains the image grading process for retinal fundus images. The system uses a three-tier grading approach to ensure quality and accuracy in disease assessment.

Understanding the Grading Workflow

The grading process follows these steps:

Resident Grading: Initial assessment by a resident
Resident2 Grading: Independent assessment by an ophthalmologist
Arbitration: Resolution of discrepancies by a senior ophthalmologist

Accessing Grading Tasks

Viewing Your Dashboard

Log in with your grading credentials
Click on "Grading" in the main menu
Your dashboard shows:
Tasks pending your review
Recently completed gradings
Statistics on your grading activity

Task Status Indicators

Tasks are color-coded by status: - Blue: Pending your review - Yellow: In progress by another grader - Green: Completed with consensus - Red: Requires arbitration

Resident Grading

Starting a Task

From your dashboard, click on a pending task
Review the patient information and image details
Examine the fundus image using the viewer tools
Select the appropriate grade for the disease

Image Viewer Tools

Zoom: Use mouse wheel or zoom buttons
Pan: Click and drag to move the image
Brightness/Contrast: Adjust using sliders
Fullscreen: Expand to full screen view
Reset: Return to original view settings

Selecting Grades

For each disease, select from these options:

Diabetic Retinopathy (DR)

No DR: No signs of diabetic retinopathy
Mild: Microaneurysms only
Moderate: More than just microaneurysms
Severe: Many hemorrhages and microaneurysms
Proliferative: Neovascularization present

Glaucoma

Normal: No signs of glaucoma
Suspect: Suspicious optic nerve or visual field
Mild: Early glaucomatous changes
Moderate: Moderate damage
Severe: Advanced glaucomatous damage

Normal: No AMD signs
Early: Small drusen only
Intermediate: Medium drusen or pigment changes
Late: Neovascular AMD or geographic atrophy

Adding Comments

Enter relevant clinical observations
Note any image quality issues
Describe uncertain areas
Include recommendations if needed

Submitting Your Grade

Review your selected grade and comments
Click "Submit" to save your assessment
Choose "Save and Next" to continue to the next task
Or choose "Save and Close" to return to the dashboard

Resident2 Grading

Accessing Tasks

Resident2 members review tasks after resident grading: 1. Go to your grading dashboard 2. Look for tasks in "Resident2 Review" status 3. Click on a task to begin your assessment

Independent Assessment

You will not see the resident's grade during your initial review
Provide your independent assessment based on medical expertise
Follow the same grading process as residents
Your grade will be compared with the resident's assessment

Grade Matching

After submission: - If grades match: Task is finalized with consensus - If grades differ: Task goes to arbitration

Arbitration Process

When Arbitration is Needed

Arbitration occurs when: - Resident and resident2 grades differ - Additional expertise is required - Quality control indicates a review is needed

Arbitrator Responsibilities

Review both previous grades
Examine the image with full context
Provide the final decision
Document reasoning for the decision

Making the Final Decision

Consider both previous assessments
Use your clinical expertise
Select the most appropriate grade
Add detailed comments explaining your reasoning

Revising Grades

When Can You Revise?

Residents: Until resident2 grading begins
Resident2: Until arbitration or finalization
Arbitrators: Within 6 hours of submission

How to Revise

Find the grade in your grading history
Click "Revise" next to the grade
Update your assessment
Add a comment explaining the revision
Submit the updated grade

Grading Best Practices

Before Grading

Ensure proper lighting: View in a well-lit environment
Minimize distractions: Focus on the grading task
Check image quality: Verify the image is clear and adequate
Review patient history: Consider relevant clinical information

During Grading

Use systematic approach: Examine all regions of the retina
Take breaks: Rest your eyes periodically
Document findings: Be thorough in your comments
When uncertain: Mark as uncertain and explain why

After Grading

Review your work: Double-check your selections
Submit promptly: Avoid unnecessary delays
Track your progress: Monitor your grading statistics
Seek feedback: Discuss challenging cases with colleagues

Quality Assurance

Consistency Checks

The system monitors for: - Consistency in your grading patterns - Time taken per image - Frequency of revisions - Comparison with peer assessments

Performance Metrics

Your dashboard shows: - Number of images graded - Average time per image - Consensus rate with other graders - Revision frequency

Troubleshooting Grading Issues

Image Display Problems

Blurry images: Report quality issues in comments
Loading errors: Refresh the page or try a different browser
Viewer tools not working: Check browser compatibility

Submission Errors

Cannot submit: Check all required fields are completed
Timeout errors: Save your work periodically
Duplicate submissions: The system prevents duplicate grades

Access Issues

Cannot see tasks: Verify your role and permissions
Tasks missing: Check filters and date ranges
Permission denied: Contact your administrator

Keyboard Shortcuts for Grading

Action	Shortcut
Next image	Right Arrow
Previous image	Left Arrow
Zoom in	+
Zoom out	-
Reset view	R
Submit grade	Ctrl + Enter
Save draft	Ctrl + S

Understanding Consensus

Match Consensus

When resident and resident2 grades agree: - Consensus is automatically created - Task is marked as final - No further action needed

Adjudication Consensus

When grades differ: - Arbitrator makes final decision - Consensus is created through adjudication - Task is marked as final

Consensus Reports

View consensus reports to understand: - Overall grading patterns - Common discrepancies - Learning opportunities