Encounter notes import from the EHR, adjudication in batch, and CTCAE synonym mapping for 184 terms

What shipped in week 11

Week 11 (the week of 9 March 2026) shipped three changes to the grading day. Encounter notes now import from a connected EHR straight into CTCAE grading, adjudicators resolve every grade disagreement on a case in a single submission, and CTCAE synonym mapping grew from 74 CTCAE terms to 184, so the engine recognizes far more of the language clinicians actually write.

Coordinators, raters and adjudicators on oncology trials see all three in their daily work. Each section below covers what changed and how it works.

Import an encounter note from the EHR in one step

EHR encounter import now runs from the grading screen itself, so the note never has to be copied out of the EHR and pasted in:

1. Find the patient. Search the connected EHR by first name, last name, date of birth or identifier, or pick a patient already synced into Burna AI.
2. Pick the encounter. Choose a start and end date, browse that patient's encounters in the range, and select one.
3. Grade it. The note text loads into the grading input, and the patient is assigned to the encounter automatically. If the wrong patient was chosen, an Undo control removes the assignment.

Under the surface, the import reads the encounter's FHIR R4 DocumentReference and Binary resources. When an encounter has no linked document, it falls back to the patient's documents, and notes stored as HTML are reduced to plain text before they reach the grading input. That week the import ran against Epic; the Oracle Health (Cerner) connection followed in week 14. For the current flow, see how Burna AI imports clinical notes from the EHR.

Batch adjudication: resolve every grade disagreement on a case at once

When two raters grade the same case independently and disagree, an adjudicator decides. Disagreement is ordinary rather than rare: when two reviewers identified CTCAE toxicities in the same 100 oncology notes, their agreement measured kappa 0.59 to 0.68, and a third reviewer settled the discrepancies (Fairchild et al., International Journal of Radiation Oncology, Biology, Physics, 2020). Until this week, each disagreement on a case needed its own submission.

The adjudication view now gathers every disagreement on a case into one tab, with a count badge on the case. For each one, the adjudicator sees each rater's grade side by side, picks the grade that stands, and submits every resolution together. Other changes in the same view:

• An adjudicator note is optional rather than required, so a clear-cut resolution does not need a written justification.
• A case with no disagreements shows an empty state instead of a blank tab.
• Selections stay in step when new disagreements arrive, so a resolution never points at a stale pair of grades.

CTCAE synonym mapping grows from 74 terms to 184

CTCAE synonym mapping connects the words a clinician writes to the CTCAE term that carries the grade. A note says "hand-foot syndrome"; the grade lives under Palmar-plantar erythrodysesthesia syndrome. When a phrase maps cleanly before the engine starts judging, fewer terms come back unmatched.

This week the map went from 74 CTCAE terms and 310 clinical phrasings to 184 terms and 1,186 phrasings. The new coverage:

• Immune-related adverse event language for checkpoint inhibitor trials
• Drug-specific shorthand such as CIPN and HFS
• CAR-T terminology, including CRS
• Radiation-specific terms, plus psychiatric, endocrine and reproductive terms
• Patient language, such as "chemo brain"

Phrase in the note	CTCAE v6.0 term it maps to
hand-foot syndrome, HFS, PPE	Palmar-plantar erythrodysesthesia syndrome
CIPN, oxaliplatin neuropathy	Peripheral sensory neuropathy
cytokine storm, CRS	Cytokine release syndrome
immune-mediated colitis	Colitis
chemo brain	Cognitive disturbance

Every key in the map was also checked against the CTCAE v6.0 term list. Two keys that are not v6.0 terms came out ("Brain fog" folded into Cognitive disturbance; "Nail changes" became Nail ridging and Nail loss). Phrasings that pointed at two different terms were resolved to one, and eight two-letter abbreviations such as FN and PE were removed because they produce false matches in running clinical text. To see the terms the map points at, browse all 850 CTCAE v6.0 terms on ctcae.ai.

A phrase the map still does not know goes to a review queue rather than being dropped; how Burna AI handles terminology that varies across institutions covers that loop.

Smaller fixes that shipped the same week

• Report generation. The report flow was repaired end to end. Characters outside the PDF font's character set no longer crash a PDF, a check stops a second AE log being generated for the same grading run, and a Retry control appears if automatic generation does not finish.
• Serious adverse event count. The count behind the clinical summary's alert banner is now computed from the current list of graded events at display time, not from a cached summary, so it cannot fall behind an edit or an adjudication.
• Recording needs a patient. An encounter must have an assigned patient before recording starts.
• Result displays. The CTCAE result and drug attribution views use collapsible sections, and drug interaction findings appear once per analysis instead of repeating under every event.
• A clearer name. The "Clinical Decision" workflow is now "Drug Interaction", which says what it does: it checks the regimen for interactions between drugs.
• One way in. Every grading run, from a recording or a typed note, now starts from a single entry point.

Since then (July 2026): the provider web app these features shipped in was retired. The platform is app.burna.ai, where encounter import sits in the EHR sync view and adjudication runs inside blind grading.

To see encounter import and adjudication against your own workflow, book a 15-minute conversation.