Abstract: Embodiments are directed towards generating reviews of exams. An exam of interest (EOI) may be anonymized and blinded. N?1 anonymized and blinded foil exams may be selected from an exam database, where N is an integer greater than 1. An anonymized and blinded exam set may be generated for review, where the exam set includes the EOI and the selected foil exams. The exam set may be provided to a reviewer. The reviewer may not be able to discriminate between the EOI and the foil exams. An assessment metric may be generated based on a review of each exam in the exam set. An assessment metric set may be generated, where the assessment metric set includes each generated assessment metric. A report may be generated based on the assessment metric set. The report may indicate a reviewer determination of an overall quality of the EOI. The report may indicate a consistency score for the reviewer, based at least on the reviews of the foil exams.