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Title of Journal: Int J Legal Med

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Abbravation: International Journal of Legal Medicine

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Springer Berlin Heidelberg

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DOI

10.1002/9781118927496.ch58

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1437-1596

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Accuracy of scoring of the epiphyses at the knee j

Authors: Ivan Galić Frane Mihanović Alice Giuliodori Federica Conforti Mariano Cingolani Roberto Cameriere
Publish Date: 2016/03/30
Volume: 130, Issue: 4, Pages: 1129-1142
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Abstract

Important aspects of forensic practice are age estimation and discrimination of individuals of unknown age as adults and minors The developing knee joint was recognized as a potential site for age examination in late adolescence We analyzed a sample of anteroposterior xrays of the knee joints from 446 living individuals from Umbria Italy 234 males and 212 females aged between 12 and 26 years We evaluated the ossification of the distal femoral DF proximal tibial PT and proximal fibular PF epiphyses We took into account possible persistence of the epiphyseal scars in the ossified epiphyses by the adopted stages of those previously introduced by Cameriere et al 2012 We also used measurements from all three epiphyses to calculate the total score of maturation for the knee joint SKJ Cohen Kappa coefficients of intrarater agreement for staging the DF PT and PF epiphyses were 0839 0894 and 0907 while interrater agreement was 0919 0791 and 0907 respectively The resulting receiver operating characteristic ROC curves of SKJ show better discriminatory power than those for DF PT and PF epiphyses in predicting that the participant either male or female was an adult or a minor The areas under the curves for SKJ were 0991 and 0968 vs 0944 0962 0974 and 0891 0910 0918 for males and females respectively The results of the 2 by 2 contingency tables showed that SKJ score of 4 in males and SKJ score of 5 in females were the most suitable cutoff value in discriminating between adults and minors Principally the sensitivity test for males was 094 with 95  confidence interval 95  CI 090 to 097 and specificity was 096 95  CI 091 to 098 The proportion of correctly classified individuals was 095 95  CI 091 to 097 For females the sensitivity test was 089 95  CI 084 to 092 and specificity was 092 95  CI 087 to 096 the proportion of correctly classified individuals was 090 95  CI 085 to 094 These results indicate that the SKJ method may give valuable supporting information in forensic procedures for discriminating individuals of legal adult age of 18 years Further studies should address the usefulness of the SKJ method in different populationsThe protocol to collect Xrays and perform the study was conducted in accordance with the ethical standards laid down by the Declaration of Helsinki The Ethics Committee for Research Involving Human Subjects of the Foligno Hospital approved the study 96

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