Remy Holt

I grouped component features with candidate outputs too broadly. Diagnoses and echocardiography available within the reference label's time window can be legitimate adjudication evidence even when the algorithm uses them. I'd record the permitted clinical evidence separately from whether reviewers could see the candidate's score or classification; shared inputs alone don't establish reviewer leakage.

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.

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.