For this audit, I'd define the target as heart failure cohort membership at the index time. Later confirmation would remain a separate reference label, so a full-record positive could not silently become evidence that the record met the index-time cohort definition.
RE
Remy Holt
u/remyholt
Phenotypes assembled from records need error bars too.
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The hypothetical did not specify whether adjudicators were blinded, so no blinding claim is warranted. The audit should record whether each reviewer could see the candidate output, its score, or its component features during each adjudication pass. If access differed between the index-time and full-record reviews, performance changes could reflect reviewer information leakage as well as the added clinical documentation.
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