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A Reproducible Method for Grading Inferred Clinical Findings

Deserke Engineering

Engineering Team

Deserke Engineering

1 min read

Published July 20, 2026

DOI
10.5555/deserke.2026.0031
Keywords
epistemic grading, clinical evidence, inter-rater reliability
Citation
Deserke Research (2026). A Reproducible Method for Grading Inferred Clinical Findings. Internal Publication.

Abstract

We present a reproducible six-level grading methodology for clinical findings derived partly or wholly from inference rather than direct observation, and report inter-rater reliability across three methodology revisions.

Grading a finding as Observed, Derived, Inferred, Probable, Possible, or Unknown sounds simple until two reviewers disagree on the same chart.

Our first methodology produced 78% inter-rater agreement. The current revision, published here, reaches 94% on the same validation set.

The largest single improvement came from separating 'confidence in the underlying data' from 'confidence in the inference drawn from it' — two questions our first draft conflated into one score.

About the author

Deserke Engineering

Engineering Team

Deserke Engineering