The utility of histology in assessing the cause of death in medico-legal autopsies in selected trauma deaths : Suspension-, immersion-, fire-, and traffic-related
(2023) In Journal of Forensic Sciences 68(2). p.509-517- Abstract
The goal of a medico-legal autopsy is primarily to determine the cause and manner of death. To this end, the pathologist often uses auxiliary analyses, including histology. However, the utility of routine histology in all medico-legal autopsies is unknown. Earlier studies on the utility of routine histology have shown inconsistent effects, with some studies recommending it and others rejecting it. To study the degree to which histology informs on the underlying cause of death, we sent autopsy reports from suspension-, immersion-, fire-, and traffic-related deaths to senior board-certified forensic pathologists and had them assess the cause of death, first without knowledge of the histological findings and then with knowledge thereof.... (More)
The goal of a medico-legal autopsy is primarily to determine the cause and manner of death. To this end, the pathologist often uses auxiliary analyses, including histology. However, the utility of routine histology in all medico-legal autopsies is unknown. Earlier studies on the utility of routine histology have shown inconsistent effects, with some studies recommending it and others rejecting it. To study the degree to which histology informs on the underlying cause of death, we sent autopsy reports from suspension-, immersion-, fire-, and traffic-related deaths to senior board-certified forensic pathologists and had them assess the cause of death, first without knowledge of the histological findings and then with knowledge thereof. Fifty cases were identified in each of four subgroups: fire-, immersion-, suspension-, and traffic-related deaths. The autopsy reports were anonymized, and the histological findings and conclusions were removed. Two board-certified forensic pathologists independently reviewed the reports in each subgroup and assessed the manner and underlying cause of death (including their certainty of this assessment on a five-level scale) with and without access to histological findings. The probability of changing the underlying cause of death posthistology was low in all study groups. There was a slight increase in the degree of certainty posthistology in cases where the underlying cause of death was not changed, but only when the antehistology certainty was low. Our results suggest that histology does not meaningfully inform on the underlying cause of death in suspension-, immersion-, fire-, and traffic-related deaths except when antehistology certainty is low.
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- author
- Beer, Torfinn ; Bäckström, Björn ; Ottosson, Anders LU ; Rietz, Anders ; Michard, Jean-François ; Loisel, Johanna ; Sandberg, Oscar and Eriksson, Anders
- organization
- publishing date
- 2023-01-16
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Forensic Sciences
- volume
- 68
- issue
- 2
- pages
- 509 - 517
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85146363512
- pmid:36645694
- ISSN
- 0022-1198
- DOI
- 10.1111/1556-4029.15193
- language
- English
- LU publication?
- yes
- additional info
- © 2023 The Authors. Journal of Forensic Sciences published by Wiley Periodicals LLC on behalf of American Academy of Forensic Sciences.
- id
- e51b7f4e-0445-415b-8aba-c683e55bad36
- date added to LUP
- 2023-01-17 13:30:38
- date last changed
- 2024-04-18 09:13:27
@article{e51b7f4e-0445-415b-8aba-c683e55bad36,
abstract = {{<p>The goal of a medico-legal autopsy is primarily to determine the cause and manner of death. To this end, the pathologist often uses auxiliary analyses, including histology. However, the utility of routine histology in all medico-legal autopsies is unknown. Earlier studies on the utility of routine histology have shown inconsistent effects, with some studies recommending it and others rejecting it. To study the degree to which histology informs on the underlying cause of death, we sent autopsy reports from suspension-, immersion-, fire-, and traffic-related deaths to senior board-certified forensic pathologists and had them assess the cause of death, first without knowledge of the histological findings and then with knowledge thereof. Fifty cases were identified in each of four subgroups: fire-, immersion-, suspension-, and traffic-related deaths. The autopsy reports were anonymized, and the histological findings and conclusions were removed. Two board-certified forensic pathologists independently reviewed the reports in each subgroup and assessed the manner and underlying cause of death (including their certainty of this assessment on a five-level scale) with and without access to histological findings. The probability of changing the underlying cause of death posthistology was low in all study groups. There was a slight increase in the degree of certainty posthistology in cases where the underlying cause of death was not changed, but only when the antehistology certainty was low. Our results suggest that histology does not meaningfully inform on the underlying cause of death in suspension-, immersion-, fire-, and traffic-related deaths except when antehistology certainty is low.</p>}},
author = {{Beer, Torfinn and Bäckström, Björn and Ottosson, Anders and Rietz, Anders and Michard, Jean-François and Loisel, Johanna and Sandberg, Oscar and Eriksson, Anders}},
issn = {{0022-1198}},
language = {{eng}},
month = {{01}},
number = {{2}},
pages = {{509--517}},
publisher = {{Wiley-Blackwell}},
series = {{Journal of Forensic Sciences}},
title = {{The utility of histology in assessing the cause of death in medico-legal autopsies in selected trauma deaths : Suspension-, immersion-, fire-, and traffic-related}},
url = {{http://dx.doi.org/10.1111/1556-4029.15193}},
doi = {{10.1111/1556-4029.15193}},
volume = {{68}},
year = {{2023}},
}