Help: user journeys

J1First login and sign-out

1. Open the invitation email and select the link to set your password. The link works once and expires at the time shown in the email.
2. Choose your password on the invitation page. It must be at least 10 characters.
3. Sign in with your email address and password.
4. To sign out, select your name and Sign out. Your session ends on this device at once.

You see: your account is ready and you can submit cases.

Notifications are sent by email. Emails never contain images, reports, names or findings. To change your notification address, ask an administrator.

J2Prepare images at your clinic

1. Export the images from the ultrasound machine to a computer, by USB or network export. Use JPEG, PNG or DICOM.
2. Save each nodule image as its own file. Do not put names, dates of birth or hospital numbers in file names.
3. Keep each file under the upload size limit shown on the upload page. Compress only if the page asks you to.
4. Check that each image shows the nodule in at least two planes, with its measurement visible.

You see: the files are ready to upload in J3.

If the machine cannot export images, tell your administrator. Do not send images by email or messaging apps.

J3Submit a caseStudy 2A

1. Select New case. Enter the study code, your site and the study arm.
2. Check the consent status for the case. A case without the required consent cannot move to review.
3. Upload the images: JPEG, PNG or DICOM. Large files resume if the connection drops.
4. Read any quality warnings (too dark, cropped, nodule not visible in two planes). Fix the image, or accept it with a note so the study team can review it.
5. Enter the report and the six core features: composition, echogenicity, shape, margins, microcalcifications and size. Add the lymph node finding.
6. Select Submit.

You see: the case status changes to Awaiting readers.

Identifiers in DICOM headers are removed automatically. If text is burned into an image, the image is held for review before readers can see it.

J4Reassessment with an upload linkStudy 2B

1. Your study coordinator asks you to reassess a patient.
2. You receive an upload link by email. It works once and expires after 24 hours.
3. Open the link and log in. If it has expired or was already used, ask an administrator to send a new one.
4. Upload the new examination images and the report, enter the EU-TIRADS fields, and select Submit.

You see: a confirmation that the examination was received.

Patients are never contacted through this platform. Invite patients as your clinic normally does.

J5Notifications, reminders and status

1. You receive an email with a case code and a link when a case needs attention, a second opinion is ready, or a due date is near.
2. Open the link and log in.
3. The case page shows its status: Open, Awaiting readers or Complete. Emails do not show status details.

Emails contain the case code and a link only. They never contain names, ages or findings.

J6Correct a submitted case

1. Open the submitted case and select Request amendment.
2. Change the field and give a reason.
3. An administrator approves or rejects the change. An approved change takes effect at once.

You see: the original value, your change and the decision are all kept in the audit log.

A submitted case cannot be edited directly. Every change is logged.

J7Give a second opinion

1. Open My queue. Each case shows its status and due date.
2. Select a case. The viewer opens the images. You can zoom, pan, and adjust the window and level. Cine clips play in the same view.
3. For each nodule, enter the six core features. The form suggests a category from those features.
4. Accept the suggested category, or change it and give a reason.
5. Set your confidence and add a comment if needed.
6. Select Submit opinion.

You see: the opinion is locked. The case moves on when all readers have submitted.

You are blinded. You do not see the original report, other readers' opinions or the cytology or histology result until you have submitted your own opinion.

J8Resolve a disagreement

1. Open Adjudication queue. Cases appear here when readers disagree under the study's rule.
2. Select a case. You see every opinion, labelled A, B and C. Reader names are hidden.
3. Review the images and the features each reader recorded.
4. Choose the final category and enter the reason.
5. Select Record final category.

You see: the nodule is marked complete, and the final category is used in the study analysis.

J9Set up a clinic and invite staff

1. Open Sites and select Add clinic. Enter the clinic's name, region and type. Record the consent route and its approval reference.
2. Invite each named submitter. Each person has their own account. Shared logins are not allowed.
3. Enter the clinic's notification email. Use a named person's address, not a shared inbox, unless the clinic agrees.
4. Send a test email from the site page and check that it arrives.

You see: the clinic appears in the site list, and its users can upload.

To change or deactivate a user later, open Users, select the user and edit. Deactivation takes effect at once.

J10Set up a study and assign readers

1. Open Studies and select New study. Add the arms (2A, 2B or pilot). For each arm, set the number of readers (two or three) and the adjudication rule. Save.
2. Open Assignments. Assign readers manually, or apply the study's rule. The system never gives a reader a case from their own site.

You see: each case shows its assigned readers and their status.

J11Clear a flagged image

1. Open Flagged images. Each image shows its warning: burned-in text, or identifiers in the file header.
2. Choose one: Clear (enter the reason), Re-export (upload a cleaned copy), or Reject (the submitter must send a new image).

You see: cleared images become visible to readers. Rejected images go back to the submitter with your note.

Readers do not see an image until it is cleared.

J12Record consent for a case

1. Open the case and select Consent.
2. Choose the consent type: written consent, a waiver approved by the ethics committee, or not required under the study.
3. Enter the date and the reference number of the approval or consent form. Save.

You see: the case can now move to review.

A case without recorded consent cannot move to review.

J13Record the reference result

1. Open the case and select Reference result.
2. Enter the cytology category (Bethesda) or the histology result, with its date.
3. Save.

Readers never see reference results before they submit their own opinion.

J14Track progress and export data

1. Open Dashboard for cases by status, reader completion and time to opinion. Open Agreement for weighted kappa with confidence intervals.
2. Open Exports, choose the study and data set, and select Create export. Exports contain study codes only and never include external datasets.
3. Download the file. The download is logged.

Exports follow the data access agreement for the study. Ask the data protection officer if you are unsure whether a data set may be shared.

J15Assess a nodule and create a reportPilot

1. Select New assessment and enter the study code for the patient.
2. Enter the six core features, the lymph node finding and the largest diameter in mm. You can assess up to two nodules per exam.
3. Read the category and the FNA recommendation. Each one shows the rule behind it. Check them against the images and your own judgement.
4. Confirm the category, or change it and give a reason. Nothing is saved until you confirm.
5. Select Create report. Choose Azerbaijani, Russian or English, check the text (including your name and the date), then select Export PDF or Print.

You see: the report is saved with the note that the treating doctor makes the final decision.

The tool does not save a result to the patient record without your confirmation.

J16Review the audit log

1. Open Audit log.
2. Filter by user, case code, action or date range.
3. Export the result for a report.

You see: every view, upload, download, opinion, email and export, with user, time and case code.