Understanding Expert Disagreement in Medical Data Analysis through Structured Adjudication

Expert disagreement is pervasive in clinical decision making and collective adjudication is a useful approach for resolving divergent assessments. Prior work shows that expert disagreement can arise due to diverse factors including expert background, the quality and presentation of data, and guideline clarity. In this work, we study how these factors predict initial discrepancies in the context of medical time series analysis, examining why certain disagreements persist after adjudication, and how adjudication impacts clinical decisions. Results from a case study with 36 experts and 4,543 adjudicated cases in a sleep stage classification task show that these factors contribute to both initial disagreement and resolvability, each in their own unique way. We provide evidence suggesting that structured adjudication can lead to significant revisions in treatment-relevant clinical parameters. Our work demonstrates how structured adjudication can support consensus and facilitate a deep understanding of expert disagreement in medical data analysis.