@article{ref1,
title="Postmortem computed tomography plus forensic autopsy for determining the cause of death in child fatalities",
journal="Pediatric radiology",
year="2022",
author="Speelman, Aladdin C. and Engel-Hills, Penelope C. and Martin, Lorna J. and van Rijn, Rick R. and Offiah, Amaka C.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Postmortem computed tomography (CT) and magnetic resonance imaging have been gradually introduced to forensic pathology centres over the past two decades, with varying results in comparison to autopsy. <br><br>OBJECTIVE: The purpose of this study was to determine the accuracy of postmortem CT in determining a cause of death in children who died of unnatural causes. <br><br>MATERIALS AND METHODS: This was a prospective recruitment of 30 children (< 18 years) who underwent postmortem CT and a forensic autopsy. A cause of death was independently assigned by two experienced paediatric radiologists and compared to that of the forensic autopsy. <br><br>RESULTS: A correct cause of death was assigned by reviewers 1 and 2 in 70% (n = 21/30) and 67% (n = 20/30) of cases, respectively. For gunshot injuries and blunt force head injuries, there was 91% (n = 10/11) and 100% (n = 6/6) agreement between forensic autopsy and both reviewers, respectively. No cause of death could be assigned by reviewers 1 and 2 in 27% (n = 8) and 30% (n = 9) of cases, respectively. An incorrect cause of death was assigned by both reviewers in one case (3%). The Cohen Kappa level of agreement between the forensic autopsy and reviewers 1 and 2 was k = 0.624 (95% confidence interval [CI]: 0.45-0.80, P = 0) and k = 0.582 (95% CI 0.41-0.76, P = 0), respectively. There was near perfect agreement between reviewers 1 and 2 (k = 0.905) (95% CI 0.78-1.00, P = 0). <br><br>CONCLUSION: Postmortem CT has good diagnostic accuracy for identifying a cause of death related to trauma, but it has poor accuracy for children dying from causes not associated with apparent physical injury.<p /> <p>Language: en</p>",
language="en",
issn="0301-0449",
doi="10.1007/s00247-022-05406-7",
url="http://dx.doi.org/10.1007/s00247-022-05406-7"
}