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Surgeon Information

Name of Surgeon Tester

Email

Test Patient Framework Information

Test Case Framework: Jill TestOne

Number of clinical scenarios tested by modifying the baseline case framework

0-10 10-25 Greater than 25

Types of modifications made

Algorithm-Generated Surgical Plan Review

Please give your overall impression if the algorithm-generated surgical plan match your expected surgical plan?

Yes No

If no, what were the differences?

How would you rate the acceptability of the plan?

Acceptable Minor Modifications Needed Unacceptable

Quantitative Rating

Overall accuracy

Relevance to clinical scenario

Suitability for implementation

Additional Comments & Feedback

Test Case Framework: Jill TestTwo

Number of clinical scenarios tested by modifying the baseline case framework

0-10 10-25 Greater than 25

Types of modifications made

Algorithm-Generated Surgical Plan Review

Please give your overall impression if the algorithm-generated surgical plan match your expected surgical plan?

Yes No

If no, what were the differences?

How would you rate the acceptability of the plan?

Acceptable Minor Modifications Needed Unacceptable

Quantitative Rating

Overall accuracy

Relevance to clinical scenario

Suitability for implementation

Additional Comments & Feedback

Test Case Framework: Jill Four

Number of clinical scenarios tested by modifying the baseline case framework

0-10 10-25 Greater than 25

Types of modifications made

Algorithm-Generated Surgical Plan Review

Please give your overall impression if the algorithm-generated surgical plan match your expected surgical plan?

Yes No

If no, what were the differences?

How would you rate the acceptability of the plan?

Acceptable Minor Modifications Needed Unacceptable

Quantitative Rating

Overall accuracy

Relevance to clinical scenario

Suitability for implementation

Additional Comments & Feedback

Test Case Framework: Jill Five

Number of clinical scenarios tested by modifying the baseline case framework

0-10 10-25 Greater than 25

Types of modifications made

Algorithm-Generated Surgical Plan Review

Please give your overall impression if the algorithm-generated surgical plan match your expected surgical plan?

Yes No

If no, what were the differences?

How would you rate the acceptability of the plan?

Acceptable Minor Modifications Needed Unacceptable

Quantitative Rating

Overall accuracy

Relevance to clinical scenario

Suitability for implementation

Additional Comments & Feedback

Test Case Framework: Jack One

Number of clinical scenarios tested by modifying the baseline case framework

0-10 10-25 Greater than 25

Types of modifications made

Algorithm-Generated Surgical Plan Review

Please give your overall impression if the algorithm-generated surgical plan match your expected surgical plan?

Yes No

If no, what were the differences?

How would you rate the acceptability of the plan?

Acceptable Minor Modifications Needed Unacceptable

Quantitative Rating

Overall accuracy

Relevance to clinical scenario

Suitability for implementation

Additional Comments & Feedback