Articlehybrid2018

Error rates for unvalidated medical age assessment procedures

30 citations0/0 files storedInternational Journal of Legal Medicine

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Forensic Anthropology and Bioarchaeology Studies Child Abuse and Related Trauma Reliability and Agreement in Measurement

Abstract

During 2014-2015, Sweden received asylum applications from more than 240,000 people, of which more than 40,000 were termed unaccompanied minors. In a large number of cases, claims by asylum seekers of being below 18 years were not trusted by Swedish authorities. To handle the situation, the Swedish national board of forensic medicine (Rättsmedicinalverket, RMV) was assigned by the government to create a centralized system for medical age assessments. RMV introduced a procedure including two biological age indicators; x-ray of the third molars and magnetic resonance imaging of the distal femoral epiphysis. In 2017, a total of 9617 males and 337 females were subjected to this procedure. No validation study for the procedure was however published, and the observed number of cases with different maturity combinations in teeth and femur were unexpected given the claims originally made by RMV. We present a general stochastic model enabling us to study which combinations of age indicator model parameters and age population profiles are consistent with the observed 2017 data for males. We find that, contrary to some RMV claims, maturity of the femur, as observed by RMV, appears on average well before maturity of teeth. According to our estimates, approximately 15% of the tested males were children. These children had an approximate 33% risk of being classified as adults. The corresponding risk for an adult to be misclassified as a child was approximately 7%. We determine uncertainties and ranges of estimates under reasonable perturbations of the prior.

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References

1973A new system of dental age assessment.2008Criteria for age estimation in living individuals 1993The A.B.F.O. Study of Third Molar Development and Its Use as an Estimator of Chronological Age 2014Forensic age estimation in living individuals using 3.0T MRI of the distal femur 2009Human dental age estimation using third molar developmental stages: does a Bayesian approach outperform regression models to discriminate between juveniles and adults?2017Forensic age estimation by magnetic resonance imaging of the knee: the definite relevance in bony fusion of the distal femoral- and the proximal tibial epiphyses using closest-to-bone T1 TSE sequence 2014Contribution of distal femur MRI to the determination of the 18-year limit in forensic age estimation 2016Forensic age estimation of living persons from the knee: Comparison of MRI with radiographs

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2020Age estimation based on magnetic resonance imaging of the ankle joint in a modern Chinese Han population 2020Dental and Skeletal Imaging in Forensic Age Estimation: Disparities in Current Approaches and the Continuing Search for Optimization 2022Forensic age assessments of alleged unaccompanied minors at the Medicolegal Institute of Montpellier: a 4-year retrospective study

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