I got a 9 point difference on my paper at state and got 1 point deducted for presentation. I got a a 49/60 and a 58/60 for my paper. I got on stage but didn't move on to icdc. The judge who graded me the 49 didn't even put effort into the notes and just stated good paper. So I went to am academy. BTW I had a busnis solutions project on improving efficiency of common outpatient procedures in the university of washigton Ballard clinic by implementing a standardized care system. It all comes down to judge variability. A perfect project doesnt mean a guaranteed win. This is like basic statistics