Through two records. Every access to patient data is written to an audit trail, row by row, which administrators review in the platform's audit log. Every grade becomes a record only when a qualified investigator signs it with a 21 CFR Part 11 electronic signature that captures what was accepted, what was overridden and the citation set as signed, so each signed grade traces to the CTCAE criterion and the line in the medical record that produced it. The graded record exports for a sponsor or a monitor.