# How Case Adverse Events are Auto-Ranked To identify the most conservative _Case Adverse Event_ as the primary event, Vault can [evaluate and rank events][1] based on your Admin's configuration. Your Admin can set the priority ranking rules to either of the following: * 1. Seriousness 2. Relatedness 3. Expectedness (default) * 1. Relatedness 2. Seriousness 3. Expectedness

Note: To auto-rank Cases that existed before this feature was introduced, you must run the Auto-Rank Case Adverse Events action.

To determine ranks for tied events, Vault applies a fixed sequence of tie-breakers using outcome, severity, CTCAE Grade, and then creation date. When complete, Vault populates the _Auto-Rank_ and _Rank_ fields on _Case Adverse Events_ and completes tagging and roll-ups. You can override Vault-populated _Ranks_. However, if you re-run auto-ranking, Vault overrides all values, including manually entered values. ## Prerequisite Your Admin must enable Auto-Ranking Case Adverse Events. ## Ranking Rules {#ranking-rules} When Vault ranks _Case Adverse Events_, Vault applies the adverse event ranking order configured by your Admin. To complete ranking, Vault evaluates: * _Seriousness_ based on the most serious _Case Adverse Event_. * The _Causality Established_ values on _Case Assessment Results_ to determine whether _Case Adverse Events_ are related to suspect products. * The _Expected_ values on _Case Assessments_ to determine the expectedness of _Case Adverse Events_. If the above evaluations result in a tie, Vault completes a fixed sequence of evaluations to determine a tie-breaker. Across _Case Adverse Events_, Vault considers: 1. The most serious _Outcome_, using the following priority: 1. _fatal_ 2. _not recovered/not resolved/ongoing_ 3. _recovering/resolving_ 4. _unknown_ or blank 5. _recovered/resolved with sequelae_ 6. _recovered/resolved_ 2. The most serious _Severity_, using the following priority: 1. _Severe_ 2. _Moderate_ 3. _Mild_ 4. Blank 3. The most serious _CTCAE Grade_, with _Grade 5_ being the most serious and blank being the least serious 4. The earliest _Created Date_ If multiple assessments with different values exist for the same _Case Adverse Event_, Vault evaluates using the most conservative values. ## When Vault Auto-Ranks {#rank-run} Depending on your Admin's configuration, Vault performs _Case Adverse Event_ auto-ranking when a _Case_ moves to an applicable lifecycle state. In addition, you can manually run auto-ranking on _Cases_ in configured lifecycle states. Refreshing ranks may be useful, for example, for Medical Reviewers updating assessment data. From the **All Actions** menu, select **Auto-Rank Case Adverse Events** (

). ## Overriding Auto-Ranking When Vault completes auto-ranking, it populates the _Auto-Rank_, _Rank_, and _Event Rank (Status)_ fields. The _Auto-Rank_ and _Event Rank (Status)_ fields are not editable. When needed, you can override Vault-populated ranks by editing the _Rank_ field. This may be necessary if you want to manually flag a primary event by entering a `1` in the _Rank_ field of a _Case Adverse Event_. When you override a Vault-populated _Rank_ value or edit the value on [any field involved in auto-ranking][1], Vault updates the _Event Rank (Status)_ field on the _Case_ from _Auto Calculated_ to _Overridden_. After you edit a _Rank_, Vault does not update the _Auto-Rank_ value.

Note: Vault always references the Rank field, and not the Auto-Rank field, as the source for rank values when evaluating reporting obligations and generating Transmissions.

If you run the _Auto-Rank Case Adverse Events_ action after manually changing ranks, Vault re-ranks all _Case Adverse Events_, including any that were manually changed. This updates the _Auto-Rank_ and _Rank_ fields. In addition, Vault updates the _Event Rank (Status)_ field from _Overridden_ to _Auto Calculated_. ## Clearing Auto-Rank Results Vault clears the _Event Rank (Status)_ field on a _Case_ and all _Auto-Rank_ fields on _Case Adverse Events_ when: * You add a _Case Adverse Event_. * An _Inbox Item_ is merged into an in-flight _Case_, regardless of whether the new information adds or changes any adverse events. To re-add auto-ranking evaluations, run the **Auto-Rank Case Adverse Events** action. ## Copying Auto-Rank Results Vault maps the _Event Rank (Status)_ field value on a _Case_ and all _Auto-Rank_ fields on _Case Adverse Events_ when: * You create a follow-up _Case_ by running the _Create Follow Up Case_ action on a _Case_. * You copy a _Case_. * Vault creates follow-up _Cases_ during bulk unblinding. [1]: #ranking-rules