Graphical depiction of entire scoring scheme. Rectangles represent tasks and measurements, ovals represent actions, and the diamond represents a simple task such as tallying. The gray shaded oval indicates a step that did not directly contribute to the procedure. Adapted with permission from: Hripcsak G, Wilcox A. Reference standards, judges, and comparison subjects: roles for experts in evaluating system performance. J Am Med Inform Assoc. 2002;9:1–15.