arXiv AI By Elisa Rovai, Fabio Rovai

One Scale, Four Texts: Gaps, Overlaps and Silent Repairs in Published Grading Schemes

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The paper investigates how different published texts for diabetic retinopathy grading—specifically four versions of an international scale and an Italian guideline—lead to gaps, overlaps, and silent repairs when interpreted literally. By transcribing these texts into a unified rule language and exhaustively enumerating over 1.4 billion finding profiles, the authors show that each text leaves some eyes uncategorized, that the 2017 tabulation contains an empty proliferative class and a macular gap absent in the 2003 text, and that English and Italian texts can order the same eyes differently. Experiments on annotated photographs and language‑model responses further reveal significant disagreements in referral decisions and persistent silent repairs even when models are instructed to read literally.

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