A scoring system for assessing the Manner of Death in Stab Injuries to the Trunk (The MODSIT score)
(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:
https://lup.lub.lu.se/record/945c3588-956a-4c0c-913c-48e587e7480c
- author
- von Linde, Maria Berg
LU
; Acosta, Stefan
LU
; Khoshnood, Ardavan M. LU
and Wingren, Carl Johan LU
- organization
- publishing date
- 2025-09-26
- 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
- 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
- 2025-09-26 07:29:59
@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}}, }