Adverse event attribution in clinical research is inconsistent, and the inconsistency reaches the drug label. In the placebo arms of two phase III trials, 47% and 50% of adverse events were recorded as related to a study drug the patients never received, and when the same event recurred in the same patient its attribution changed at least once in 31% to 36% of cases (Hillman et al., J Clin Oncol 2010). Two reviewers identifying CTCAE toxicities in the same 100 notes agreed at a weighted kappa of 0.59 and an unweighted kappa of 0.68 (Fairchild et al., Int J Radiat Oncol Biol Phys 2020). Burna AI prepares each grade with its source sentence, the CTCAE criterion it meets and per-drug WHO-UMC and Kramer attribution, so every investigator reviews the same kind of evidence and makes the call. Grading one event by hand commonly takes 15 to 20 minutes; with the evidence prepared, the investigator's time goes to review and signature.