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How does the First Draft prelude threshold work?

Answer / Solution


Many times an author will start a dictation by listing some information to include on the ADT screen for the report. This can include the patient’s name, MRN, and who the report should be copied to. This "prelude" typically doesn't belong in the typed narrative and usually does not generate good recognition output because it contains proper names. For many dictators, therefore, it is desirable to begin the First Draft text results after the first section heading of the report is detected. The First Draft prelude threshold feature seeks to eliminate the text generated for that prelude so that your MTs don’t need to see it or delete it.  It is specified in the Fast Start Settings section of the First Draft Tuning tab:

Here is a timeline of a dictation showing the relationship of the prelude threshold setting (12 sec in the example) and the first detected heading (at 7 sec in this example):

However, due to the dynamic nature of heading detection (and due to some doctors’ dictating habits) First Draft may not recognize the first heading. In order to accommodate this scenario, a cutoff is specified in seconds which specifies the point at which First Draft will just output everything it has recognized (including the prelude). If a heading is detected before that cutoff time, then everything before the heading is eliminated from the First Draft. If no heading is detected before this cutoff, then the assumption is that First Draft probably missed the first heading, so that elimination does not take place.  Here is a timeline of a dictation showing the relationship of the prelude threshold setting (12 sec in this example) and the first detected heading occurring later in the timeline (at 16sec in this example):

The default value for this cutoff is 40 seconds. If your Authors consistently take longer than this to dictate the prelude to a report, then you may want to increase the cutoff for those Authors or for your entire Account. Conversely, if you have an Author who dictates a very short prelude, and he or she does not consistently dictate the first heading, but he or she DOES dictate the second heading within the cutoff time, then you may want to lower the value. Otherwise, the entire first section of the First Draft will be eliminated because it precedes the first detected heading.

This setting is maintained on the Tuning sub-tab under the First Draft tab in the IMC.  It can be established globally for the Account and administrators can also establish a prelude threshold for specific Authors to override the Account setting.


  • Once this setting is changed and saved it will not modify existing drafts for jobs already on the platform.  This setting change would be applied to new drafts dictated after you make the change.

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Last Updated
Tuesday, September 4, 2018

First Draft, ADT prelude, heading detection, KB546
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