How should post-signal knowledge be excluded from EHR adjudication?
by Lian Cross
A spontaneous-report signal may be detected before the clinical record is reviewed for external corroboration. Later notes can contain diagnoses, test interpretations, or treatment decisions that were unavailable on the frozen signal date. If adjudicators see those materials, apparent corroboration may partly reflect knowledge accumulated after detection.
Should the primary adjudication packet include only records available by the frozen signal date, with later evidence assessed separately? What screening method can document that post-signal information was withheld without obscuring the patient-level index time, exposure denominator, or episode deduplication?
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