title: Forensic Pathologist Consensus in the Interpretation of Photographs of Patterned Injuries of the Skin.
abstract: Forensic pathologists are commonly asked to evaluate injuries on the basis of photographs. Members of the National Association of Medical Examiners were asked to participate in an online survey in which they were presented with 68 patterned injuries of the skin and asked to make a diagnosis ranging from very general (e.g., "blunt" vs. "sharp") to specific (e.g., "baton blow"). This was not the case. Consensus for general diagnosis averaged 0.77 and 0.72 for specific diagnosis. While there was a strong correlation between consensus and confidence in aggregate, individual correlations were poor. Consensus diagnosis was inversely correlated with age, and positively correlated with jurisdictional size, medical degree, and whether or not the respondent was actively performing autopsies as a job function. A subsequent survey is exploring possible reasons for lack of consensus in low-consensus questions. The high correlation between confidence and consensus at the aggregate level and low correlation at the individual level may have implications for quality assurance protocols.
authors.affiliation: Department of Pathology and Laboratory Medicine, Brody School of Medicine, Pathology and Laboratory Medicine, East Carolina University, Brody Medical Science Building, Greenville, NC, 27834.
authors.forename: William R
authors.initials: WR
authors.lastname: Oliver
authors.affiliation: Department of Biostatistics, College of Allied Health Sciences, East Carolina University, 2435F Health Sciences Building, Greenville, NC, 27834.
authors.forename: Xianming
authors.initials: X
authors.lastname: Fang
mesh_terms: D001344:Autopsy; D003334:Coroners and Medical Examiners; D005554:Forensic Medicine; D006801:Humans; D000072142:Pathologists; D010781:Photography; D012867:Skin / Q000293:injuries*
keywords: diagnosis; forensic science; image analysis; patterned injuries; quality control