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The usefulness of a trauma probability of survival model for forensic life-threatening danger assessments

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@article{c4320e56e1e046d39d6c5ffb7530225f,
title = "The usefulness of a trauma probability of survival model for forensic life-threatening danger assessments",
abstract = "Clinical forensic medical examinations constitute an increasing proportion of our institution's tasks, and, concomitantly, the authorities are now requesting forensic life-threatening danger assessments based on our examinations. The aim of this retrospective study was to assess if a probability of survival (PS) trauma score could be useful for these forensic life-threatening danger assessments and to identify a cut-off PS score as a supporting tool for the forensic practice of assessing life-threatening danger. We compared a forensic database and a trauma database and identified 161 individuals (aged 15 years or older) who had both a forensic life-threatening danger assessment and a PS score. The life-threatening danger assessments comprised the following statements: was not in life-threatening danger (NLD); could have been in life-threatening danger (CLD); or was in life-threatening danger (LD). The inclusion period was 2012-2016. A statistically significant difference was found in the PS scores between NLD, CLD and LD (chi-square test: p < 0.0001). The usefulness of the PS score for categorizing life-threatening danger assessments was determined by a receiver-operator characteristic (ROC) curve. The area under the curve was 0.76 (95% CI, 0.69 to 0.84) and the ROC curve revealed that a cut-off PS score of 95.8 would appropriately identify LD. Therefore, a PS score below 95.8 would indicate life-threatening danger. We propose a further exploration of how the evidence-based PS score, including a cut-off value, might be implemented in clinical forensic medical statements to add to the scientific strength of these statements.",
keywords = "AUC-ROC, Clinical forensic medicine, Life-threatening danger assessment, Objective injury severity, Penetrating injury",
author = "Jakobsen, {Lykke Schr{\o}der} and Niels Lynnerup and Jacob Steinmetz and Jytte Banner",
year = "2021",
month = may,
doi = "10.1007/s00414-020-02499-3",
language = "English",
volume = "135",
pages = "871--877",
journal = "International Journal of Legal Medicine (Print)",
issn = "0937-9827",
publisher = "Springer",
number = "3",

}

RIS

TY - JOUR

T1 - The usefulness of a trauma probability of survival model for forensic life-threatening danger assessments

AU - Jakobsen, Lykke Schrøder

AU - Lynnerup, Niels

AU - Steinmetz, Jacob

AU - Banner, Jytte

PY - 2021/5

Y1 - 2021/5

N2 - Clinical forensic medical examinations constitute an increasing proportion of our institution's tasks, and, concomitantly, the authorities are now requesting forensic life-threatening danger assessments based on our examinations. The aim of this retrospective study was to assess if a probability of survival (PS) trauma score could be useful for these forensic life-threatening danger assessments and to identify a cut-off PS score as a supporting tool for the forensic practice of assessing life-threatening danger. We compared a forensic database and a trauma database and identified 161 individuals (aged 15 years or older) who had both a forensic life-threatening danger assessment and a PS score. The life-threatening danger assessments comprised the following statements: was not in life-threatening danger (NLD); could have been in life-threatening danger (CLD); or was in life-threatening danger (LD). The inclusion period was 2012-2016. A statistically significant difference was found in the PS scores between NLD, CLD and LD (chi-square test: p < 0.0001). The usefulness of the PS score for categorizing life-threatening danger assessments was determined by a receiver-operator characteristic (ROC) curve. The area under the curve was 0.76 (95% CI, 0.69 to 0.84) and the ROC curve revealed that a cut-off PS score of 95.8 would appropriately identify LD. Therefore, a PS score below 95.8 would indicate life-threatening danger. We propose a further exploration of how the evidence-based PS score, including a cut-off value, might be implemented in clinical forensic medical statements to add to the scientific strength of these statements.

AB - Clinical forensic medical examinations constitute an increasing proportion of our institution's tasks, and, concomitantly, the authorities are now requesting forensic life-threatening danger assessments based on our examinations. The aim of this retrospective study was to assess if a probability of survival (PS) trauma score could be useful for these forensic life-threatening danger assessments and to identify a cut-off PS score as a supporting tool for the forensic practice of assessing life-threatening danger. We compared a forensic database and a trauma database and identified 161 individuals (aged 15 years or older) who had both a forensic life-threatening danger assessment and a PS score. The life-threatening danger assessments comprised the following statements: was not in life-threatening danger (NLD); could have been in life-threatening danger (CLD); or was in life-threatening danger (LD). The inclusion period was 2012-2016. A statistically significant difference was found in the PS scores between NLD, CLD and LD (chi-square test: p < 0.0001). The usefulness of the PS score for categorizing life-threatening danger assessments was determined by a receiver-operator characteristic (ROC) curve. The area under the curve was 0.76 (95% CI, 0.69 to 0.84) and the ROC curve revealed that a cut-off PS score of 95.8 would appropriately identify LD. Therefore, a PS score below 95.8 would indicate life-threatening danger. We propose a further exploration of how the evidence-based PS score, including a cut-off value, might be implemented in clinical forensic medical statements to add to the scientific strength of these statements.

KW - AUC-ROC

KW - Clinical forensic medicine

KW - Life-threatening danger assessment

KW - Objective injury severity

KW - Penetrating injury

UR - http://www.scopus.com/inward/record.url?scp=85098574138&partnerID=8YFLogxK

U2 - 10.1007/s00414-020-02499-3

DO - 10.1007/s00414-020-02499-3

M3 - Journal article

C2 - 33388971

VL - 135

SP - 871

EP - 877

JO - International Journal of Legal Medicine (Print)

JF - International Journal of Legal Medicine (Print)

SN - 0937-9827

IS - 3

ER -

ID: 61678166