Why did Nnenna John start Burna AI?

Because adverse event grading and attribution decide what a drug's safety profile says, and the investigator makes those calls with little support at the moment of documentation. Conversations with oncologists, research coordinators and pharmacovigilance leaders kept returning to the same gap: two reviewers identifying CTCAE toxicities in the same notes agreed at a kappa of 0.59 to 0.68 (Fairchild et al., 2020), and when the same adverse event recurred in the same patient, its attribution changed at least once in 31 to 36% of cases (Hillman et al., JCO 2010). Her years building platform infrastructure at Airbnb shaped the answer: an architecture in which every grade traces to the line in the medical record that produced it, the reasoning behind each attribution is shown, and a clinician signs every result. The aim is to help elucidate the safety profile, from first-in-human trials through postmarket surveillance.