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A scoring system for assessing the Manner of Death in Stab Injuries to the Trunk (The MODSIT score)

von Linde, Maria Berg LU ; Acosta, Stefan LU orcid ; Khoshnood, Ardavan M. LU orcid and Wingren, Carl Johan LU (2025) In Forensic Science International 377. p.1-6
Abstract
Introduction Distinguishing between homicide and suicide in cases of single stab injuries to the trunk can be challenging, particularly in the absence of clear contextual information. This study aims to address this issue by developing the MODSIT score (Manner of Death in Stab Injuries to the Trunk)—an evidence-based scoring system designed to standardise forensic manner of death assessments. Method We developed four score models based on: 1) autopsy findings alone; 2) autopsy findings and toxicology; 3) autopsy findings, toxicology, and circumstances at the death scene; and 4) autopsy findings, toxicology, death scene circumstances, and demographics. The diagnostic performance of the models was evaluated through Receiver Operating... (More)
Introduction Distinguishing between homicide and suicide in cases of single stab injuries to the trunk can be challenging, particularly in the absence of clear contextual information. This study aims to address this issue by developing the MODSIT score (Manner of Death in Stab Injuries to the Trunk)—an evidence-based scoring system designed to standardise forensic manner of death assessments. Method We developed four score models based on: 1) autopsy findings alone; 2) autopsy findings and toxicology; 3) autopsy findings, toxicology, and circumstances at the death scene; and 4) autopsy findings, toxicology, death scene circumstances, and demographics. The diagnostic performance of the models was evaluated through Receiver Operating Characteristic (ROC) curve analysis. Results Model 3, including autopsy findings, toxicology, and circumstances at the death scene, established the best diagnostic performance (AUC 0.99, 95% CI 0.97–1.00). The optimal cut-off of 2 score points showed 91.8% sensitivity and 97.6% specificity for predicting homicide, and cut-off of –1 point showed 85.7% sensitivity and 98.8% specificity for predicting suicide. Discussion and conclusion The score needs to be validated in other populations to confirm its generalisability. The MODSIT score has the potential to become a valuable tool for evidence-based forensic practice. (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Forensic pathology, Homicide, Suicide, Sharp force, Single stab, Score
in
Forensic Science International
volume
377
article number
112666
pages
1 - 6
publisher
Elsevier
external identifiers
  • scopus:105016892968
ISSN
0379-0738
DOI
10.1016/j.forsciint.2025.112666
project
A forensic epidemiological approach to stab injuries to the trunk
language
English
LU publication?
yes
id
945c3588-956a-4c0c-913c-48e587e7480c
date added to LUP
2025-09-22 22:47:53
date last changed
2025-10-14 12:17:59
@article{945c3588-956a-4c0c-913c-48e587e7480c,
  abstract     = {{Introduction Distinguishing between homicide and suicide in cases of single stab injuries to the trunk can be challenging, particularly in the absence of clear contextual information. This study aims to address this issue by developing the MODSIT score (Manner of Death in Stab Injuries to the Trunk)—an evidence-based scoring system designed to standardise forensic manner of death assessments. Method We developed four score models based on: 1) autopsy findings alone; 2) autopsy findings and toxicology; 3) autopsy findings, toxicology, and circumstances at the death scene; and 4) autopsy findings, toxicology, death scene circumstances, and demographics. The diagnostic performance of the models was evaluated through Receiver Operating Characteristic (ROC) curve analysis. Results Model 3, including autopsy findings, toxicology, and circumstances at the death scene, established the best diagnostic performance (AUC 0.99, 95% CI 0.97–1.00). The optimal cut-off of 2 score points showed 91.8% sensitivity and 97.6% specificity for predicting homicide, and cut-off of –1 point showed 85.7% sensitivity and 98.8% specificity for predicting suicide. Discussion and conclusion The score needs to be validated in other populations to confirm its generalisability. The MODSIT score has the potential to become a valuable tool for evidence-based forensic practice.}},
  author       = {{von Linde, Maria Berg and Acosta, Stefan and Khoshnood, Ardavan M. and Wingren, Carl Johan}},
  issn         = {{0379-0738}},
  keywords     = {{Forensic pathology; Homicide; Suicide; Sharp force; Single stab; Score}},
  language     = {{eng}},
  month        = {{09}},
  pages        = {{1--6}},
  publisher    = {{Elsevier}},
  series       = {{Forensic Science International}},
  title        = {{A scoring system for assessing the Manner of Death in Stab Injuries to the Trunk (The MODSIT score)}},
  url          = {{http://dx.doi.org/10.1016/j.forsciint.2025.112666}},
  doi          = {{10.1016/j.forsciint.2025.112666}},
  volume       = {{377}},
  year         = {{2025}},
}