Postmortem imaging findings and cause of death determination compared with autopsy: a systematic review of diagnostic test accuracy and meta-analysis.
Adult
Autopsy
/ methods
Blood Gas Analysis
Bone and Bones
/ diagnostic imaging
Cause of Death
Computed Tomography Angiography
/ standards
Hemorrhage
/ diagnostic imaging
Humans
Magnetic Resonance Imaging
/ standards
Reference Standards
Sensitivity and Specificity
Tomography, X-Ray Computed
/ standards
Diagnostic test accuracy
Meta-analysis
Postmortem computed tomography
Postmortem computed tomography angiography
Postmortem cross-sectional imaging
Postmortem magnetic resonance imaging
Journal
International journal of legal medicine
ISSN: 1437-1596
Titre abrégé: Int J Legal Med
Pays: Germany
ID NLM: 9101456
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
21
12
2018
accepted:
06
08
2019
pubmed:
29
8
2019
medline:
15
9
2020
entrez:
29
8
2019
Statut:
ppublish
Résumé
The aim of this study was to evaluate the sensitivity of postmortem computed tomography (PMCT), postmortem magnetic resonance imaging (PMMR) and PMCT angiography (PMCTA) compared with autopsy in cases of adult death investigations. For this systematic review and meta-analysis, Embase, PubMed, Scopus, Web of Science and Medline were searched for eligible studies in October 2016; a follow-up literature search was conducted in March 2018. Studies referring to PMCT, PMCTA and/or PMMR of more than 3 cases with subsequent autopsy were included. Data were extracted from published texts in duplicate. The extracted outcomes were categorized as follows: soft tissue and organ findings, skeletal injuries, haemorrhages, abnormal gas accumulations and causes of death. The summary measure was sensitivity, if 3 or more studies were available. To combine studies, a random effects model was used. Variability and heterogeneity within the meta-analysis was assessed. Of 1053 studies, 66 were eligible, encompassing a total of 4213 individuals. For soft tissue and organ findings, there was a high pooled sensitivity with PMCTA (0.91, 95% CI 0.81-0.96), without evidence for between-study variability (Cochrane's Q test p = 0.331, I Distinct postmortem imaging modalities can achieve high sensitivities for detecting various findings and causes of death. This knowledge should lead to a reasoned use of each modality. Both forensic evidence and in-hospital medical quality would be enhanced.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of this study was to evaluate the sensitivity of postmortem computed tomography (PMCT), postmortem magnetic resonance imaging (PMMR) and PMCT angiography (PMCTA) compared with autopsy in cases of adult death investigations.
METHODS
METHODS
For this systematic review and meta-analysis, Embase, PubMed, Scopus, Web of Science and Medline were searched for eligible studies in October 2016; a follow-up literature search was conducted in March 2018. Studies referring to PMCT, PMCTA and/or PMMR of more than 3 cases with subsequent autopsy were included. Data were extracted from published texts in duplicate. The extracted outcomes were categorized as follows: soft tissue and organ findings, skeletal injuries, haemorrhages, abnormal gas accumulations and causes of death. The summary measure was sensitivity, if 3 or more studies were available. To combine studies, a random effects model was used. Variability and heterogeneity within the meta-analysis was assessed.
RESULTS
RESULTS
Of 1053 studies, 66 were eligible, encompassing a total of 4213 individuals. For soft tissue and organ findings, there was a high pooled sensitivity with PMCTA (0.91, 95% CI 0.81-0.96), without evidence for between-study variability (Cochrane's Q test p = 0.331, I
CONCLUSION
CONCLUSIONS
Distinct postmortem imaging modalities can achieve high sensitivities for detecting various findings and causes of death. This knowledge should lead to a reasoned use of each modality. Both forensic evidence and in-hospital medical quality would be enhanced.
Identifiants
pubmed: 31455980
doi: 10.1007/s00414-019-02140-y
pii: 10.1007/s00414-019-02140-y
doi:
Types de publication
Comparative Study
Evaluation Study
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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