Reading Tool

Overview

The Reading Tool enables structured and controlled reading sessions for medical imaging studies. It is designed for both individual and multi-reader scenarios — supporting reproducible reading performance measurements, rater comparison, and annotation-based tasks.
Readings can be configured flexibly: randomized, blinded, repeated, or staged, depending on the study design. Results are stored securely and can be reviewed or exported by reading administrators.

Use Cases

Controlled Reading Studies: Measure inter- and intra-rater performance, reproducibility, or the impact of AI assistance.
Annotation Tasks: When a single reader annotates or tags cases manually, using the patient table and tag system may be more practical.
Training Scenarios: Allow readers to familiarize themselves with representative cases before entering a serious reading phase

Key Features

1. Forms & Rating

Create rating forms or questionnaires using the form designer.
Readers fill out these forms during reading sessions.
Form items can optionally be linked to tags in the patient or study table.

2. Image Interaction

Draw annotations, points, or ROIs directly on the images.
Combine with predefined autoloaders to automatically load the correct images and view settings.

3. Reading Modes

Individual Mode: Each rater works independently.
Joint Mode: Multiple raters collaborate on the same session.
Blind Modes: Control what metadata or previous results are visible to the reader.

4. Randomization & Repetition

Readings can be randomized per patient, study, or image.
Repetitions are supported to evaluate reproducibility.
Randomization can be deterministic or fully random.
Staged Readings: Different stages can present varying image contexts (e.g., raw vs. AI-assisted).

5. Training vs. Serious Mode

Training Mode: Assign selected cases for practice.
Serious Mode: Conduct the actual study under controlled conditions.

6. Workflow Control

Access to the patient table can be restricted or detached for fully controlled sessions.
Timing of each reading is automatically tracked.
Optionally include reading instructions or external links (e.g., Google Slides presentations).

Data & Results

All form entries, annotations, and timing data are stored in the NORA database.
Reading results can be reviewed and exported as CSV files by the reading administrator.

Usage of Reading Tool

Open the reading tool (R) in vertical toolbar

A list of all readings you have permission to access will appear.

The current progress for each reading is displayed as a numerical indicator showing how many cases have been completed out of the total. To start or continue a reading, click the corresponding button. If available, the Info button opens the reading instructions provided for that session. The Wrench button allows editing of the reading configuration, while the List button displays the collected reading results. To check for newly assigned readings or updates, click Refresh from Server to synchronize with the latest data.

Configure a reading

Click Create New Reading or the Wrench button to edit an existing one. The Form Designer will appear.

general tab

In the general tab, basic settings can be set.

form tab

In the Form tab, define the reading form using JSON code.
Click a template element on the left to copy its JSON snippet, then paste it with Ctrl+V or click the arrow to insert it directly at the cursor position.
Use Preview → to check the JSON and view the rendered form on the right.
Add the property "useastag": 1 to radio or checkbox elements if you want them to act as tags in the patient table.

reading tab

This json contain the reading configuration. It consist of several major variables: reading, tools, and viewer.
Most properties are self-explanatory; additional details for specific options are provided below.

For a new reading, it may be empty. If so, go to the reading_template tab and copy the relevant code to start.
The reading_template contains a template for a basic reading. The viewer property always contains the current viewer settings including the autoloaders.
So if you want to change the autoloader / viewer settings, you can modify your current view accordingly, go to reading_template, at copy only the viewer portion or the relevant parts of it.

Training and serious mode

The properties mode_serious and mode_training define the respective configurations for these two stages.
Typically, training cases are marked with a study tag such as "training" and selected using an SQL condition like:
SQLCondition: "STAG LIKE '%Training%'".
This allows readers to practice on predefined cases before proceeding to the serious reading phase.

Randomization

By default, readings follow the order defined in viewer.sortOrder and viewer.sortDirection.
To enable randomization, adjust the random property with one of these options:

"none" – no randomization (default)
"full" – generates a completely random and unpredictable order for each user and session.
"idhash" – creates a hash based on the StudyID, resulting in a random but reproducible order that remains consistent across users and sessions.

Debugging and restart

with the options allowRestartOfTraining and allowRestartOfTraining the respective reading can be restarted, i.e. all previous results of the current user will be deleted.
This is typically not required and desired, but good for setting up and testing the reading.

Important Notes

Always test a complete reading run first — ideally on a small subset of cases defined through the SQLCondition — to ensure that all settings and logic work as intended.
After the test, review the results table to verify that data is stored and displayed correctly.
Before starting the official reading and involving other readers, it is strongly recommended to consult with the system administrators to confirm that the setup is correct and stable, avoiding wasted time and effort.