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Thicot F, Egger C, Castiglioni C, Magnin V, Boudabbous S, Angelakopoulos N, Grabherr S, Genet P. Forensic age estimation at the University Center of Legal Medicine Lausanne-Geneva: a retrospective study over 12 years. Int J Legal Med 2024; 138:1881-1889. [PMID: 38740629 PMCID: PMC11306310 DOI: 10.1007/s00414-024-03254-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024]
Abstract
With the undeniable increase in asylum requests from unaccompanied alleged minors, age estimation of living individuals has become an essential part of the routine work in European forensic centers. This study aims to review the forensic age estimations performed in our center since 2010, to evaluate the state-of-the-art of this practice in Switzerland with the evolution of the methodology according to upcoming recommendations. Our institute's expert reports performed between 2010 and 2022 were retrospectively analyzed. We gathered the following parameters: demographic data, morphological characteristics, alleged age compared with the assessed minimum age, sexual maturation, dental and bone age. When available, we collected personal and family history, medical history, records of torture-related/self-inflicted injuries, and information about eating habits that might affect skeletal development. Data collection amounted to 656 cases. Forensic age estimations ordered by the Swiss Secretariat for Migration (SEM) represented 76.4% of cases, with 23.6% of them ordered by the Court/Public Prosecutor. Most alleged minors were male (94.5%) and came from Afghanistan (53.4%). Adjunction of CT scans of the sternoclavicular joints was necessary in 86.4% of cases. Only 25.2% of our reports concluded on most probable minority, with 55.6% of definite majors; in 19.2% of our cases, minority could not be excluded. This study aspires to further broaden our expertise regarding forensic age estimations. Given the increasing migratory flows, we can expect a notable increase in the frequency of these requests. Consequently, this study aims to promote a multidisciplinary approach and the international standardization of the methodology of these estimations.
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Affiliation(s)
- Frederique Thicot
- Unit of Forensic Medicine, University Center of Legal Medicine Lausanne-Geneva (CURML), Geneva University Hospitals and University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland.
| | - Coraline Egger
- Unit of Forensic Medicine, University Center of Legal Medicine Lausanne-Geneva (CURML), Geneva University Hospitals and University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland
| | - Claudia Castiglioni
- Unit of Forensic Medicine, University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Chemin de La Vulliette 4, 1000, Lausanne 25, Switzerland
| | - Virginie Magnin
- Unit of Forensic Medicine, University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Chemin de La Vulliette 4, 1000, Lausanne 25, Switzerland
| | - Sana Boudabbous
- Radiology Division, Diagnostic Department, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Nikolaos Angelakopoulos
- Unit of Forensic Medicine, University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Chemin de La Vulliette 4, 1000, Lausanne 25, Switzerland
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Silke Grabherr
- Unit of Forensic Medicine, University Center of Legal Medicine Lausanne-Geneva (CURML), Geneva University Hospitals and University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland
- Unit of Forensic Medicine, University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Chemin de La Vulliette 4, 1000, Lausanne 25, Switzerland
| | - Pia Genet
- Unit of Forensic Medicine, University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Chemin de La Vulliette 4, 1000, Lausanne 25, Switzerland
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2
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Rudolphi F, Steffens L, Shay D, Smit C, Robinson L, Bernitz H, Schmeling A, Timme M. Insights into dental age estimation: introducing multiple regression data from a Black South African population on modified gustafson's criteria. Int J Legal Med 2024:10.1007/s00414-024-03312-1. [PMID: 39168896 DOI: 10.1007/s00414-024-03312-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 08/09/2024] [Indexed: 08/23/2024]
Abstract
Dental Age Estimation (DAE) is an effective instrument of the rule of law for verifying dubious age claims in living individuals. Once tooth development is complete, only degenerative dental characteristics can be used for this purpose. The influence of ethnicity on these degenerative dental characteristics has not been clarified.Degenerative changes were examined using modified Gustafson's criteria including secondary dentin formation, cementum apposition, periodontal recession and attrition using the Olze et al. (2012) staging scales. Orthopantomograms of 1882 black South Africans, consisting of 934 females and 948 males, from 12.00 to 40.96 years of chronological age were utilized. Two independent examiners performed the evaluations, with one of the two evaluating all radiographs twice.The relationship between individual characteristics and chronological age was analyzed using multiple regression analysis with chronological age as the dependent variable. The resulting R2 values ranged from 0.22 to 0.35, and the standard error of estimate were between 6.6 and 7.3 years. The correlation with age was consistently lower for females compared to males. The characteristic of cementum apposition emerged as critical in this population, due to a particularly low correlation with age and observer agreements partly in the "slight" range. The formula's values for the correlation with age were in general below the literature values for other populations. Overall, the limited precision of the age estimation by the formulae presented, especially for females, must be emphasized. The question of whether ethnicity per se exerts an influence on the characteristics in question, or whether the different socio-economic status, which encompasses factors such as nutrition and healthcare, is the determining factor, needs to be assessed in future studies.
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Affiliation(s)
- Fabian Rudolphi
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Laurin Steffens
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Denys Shay
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Chané Smit
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, Gauteng, South Africa
| | - Liam Robinson
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, Gauteng, South Africa
| | - Herman Bernitz
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, Gauteng, South Africa
| | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Maximilian Timme
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany.
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3
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Timme M, Viktorov J, Steffens L, Streeter A, Karch A, Schmeling A. Dental age assessment in the living: a comparison of two common stage classifications for assessing radiographic visibility of the root canals in mandibular third molars. Int J Legal Med 2024; 138:499-507. [PMID: 37952073 PMCID: PMC10861756 DOI: 10.1007/s00414-023-03121-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
After dentition is complete, degenerative tooth characteristics can be used for dental age assessment. Radiological assessment of the visibility of the root canals of the mandibular third molars in dental panoramic radiographs (DPRs) is known to be one such suitable feature. Essentially, two different stage classifications are available for evaluating the visibility of the root canals of mandibular third molars in the DPR. The aim of this study was to determine if one method outperforms the other. Therefore, the 2010 method of Olze et al. was directly compared to the 2017 method of Lucas et al. in the 2020 modification of Al Qattan et al. To this end, 233 DPRs from 116 females and 117 males aged 20.0 to 40.9 years were evaluated by three independent experienced examiners. In addition, one examiner ran two independent evaluations. Correlation between age and stage was investigated, and the inter- and intra-rater reliability was estimated for both methods. Correlation between age and stage was higher with the Olze method (Spearman rho 0.388 [95% CI 0.309, 0.462], males and 0.283 [95% CI 0.216, 0.357], females) than the Lucas method (0.212 [95% CI 0.141, 0.284], males and 0.265 [95% CI 0.193, 0.340], females). The intra-rater repeatability of the Olze method (Krippendorff's α = 0.576 [95% CI 0.508, 0.644], males and α = 0.592 [95% CI 0.523, 0.661], females) was greater than that for the Lucas method (intra-rater α = 0.422 [95% CI 0.382, 0.502], males and α = 0.516 [95% CI 0.523, 0.661], females). Inter-rater reproducibility was also greater for the Olze method (α = 0.542 [95% CI 0.463, 0.620], males and α = 0.533 [95% CI 0.451, 0.615], females) compared to the Lucas method (α = 0.374 [95% CI 0.304, 0.443], males and α = 0.432 [95% CI 0.359, 0.505], females). The method of Olze et al. was found to present marginal advantages to the Lucas et al. method across all examinations and may be a more appropriate method for application in future studies.
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Affiliation(s)
- Maximilian Timme
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany.
| | - Jan Viktorov
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Laurin Steffens
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Adam Streeter
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Münster, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Münster, Germany
| | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
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Ruder TD, Kuhnen SC, Zech WD, Klaus JB, Lombardo P, Ith M. Standards of practice in forensic age estimation with CT of the medial clavicular epiphysis-a systematic review. Int J Legal Med 2023; 137:1757-1766. [PMID: 37691040 PMCID: PMC10567934 DOI: 10.1007/s00414-023-03061-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/08/2023] [Indexed: 09/12/2023]
Abstract
The AGFAD (Arbeitsgemeinschaft für Forensische Alterdiagnostik, Study Group on Forensic Age Diagnostics) has published several recommendations regarding both technical aspects of computed tomography (CT) of the medial clavicular epiphysis (MCE) and the process of reading and interpreting the CT images for forensic age estimations (FAE). There are, however, no published recommendations regarding CT scan protocols and no dose reference values for CT of the MCE. The objective of this analysis was to assess adherence to AGFAD recommendations among practitioners of FAE and analyse reported dose-relevant CT scan parameters with the objective of helping to establish evidence-based dose reference values for FAE. A systematic literature search was conducted in PubMed and in Google Scholar with specific MeSH terms to identify original research articles on FAE with CT of the MCE from 1997 to 2022. A total of 48 studies were included. Adherence to AGFAD recommendations among practitioners of FAE is high regarding the use of Schmeling main stages (93%), bone window (79%), ≤ 1 mm CT slices (67%), axial/coronal CT images (65%), and Kellinghaus sub-stages (59%). The reporting of CT technique and CT dose-relevant scan parameters is heterogeneous and often incomplete in the current literature. Considering the success achieved by the AGFAD in creating standards of practice of FAE in living subjects, there is potential for the AGFAD to establish standards for radiation protection in FAE as well.
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Affiliation(s)
- Thomas D Ruder
- Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland.
| | - Saskia C Kuhnen
- Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Wolf-Dieter Zech
- Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| | - Jeremias B Klaus
- Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
- Institute of Forensic Medicine, University of Bern, Bern, Switzerland
- Roentgen Institute Thun, Thun, Switzerland
| | - Paolo Lombardo
- Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Michael Ith
- Institute of Diagnostic, Interventional and Pediatric Radiology, InselspitaI, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
- Radiation Protection, Image Processing Systems & Radiological Processes, Hirslanden Private Hospital Group, Zurich, Switzerland
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5
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Taranilla Castro AM, Pujol-Robinat A, Badía García MA, Milián Sebastià S, Martínez Alcázar H, Pomés Tallo J, Oleaga Zufiría L, Xifró Collsamata A. Forensic age estimation in Barcelona: analysis of expert reports issued between 2011 and 2018. Int J Legal Med 2023; 137:395-402. [PMID: 36507962 PMCID: PMC9743109 DOI: 10.1007/s00414-022-02926-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION In recent years, there has been a notable increase of migratory movements into Europe with the arrival of not (reliably) documented young individuals within EU-Member States. Accordingly, the need for forensic age assessments likewise increased in order to administratively differentiate along the legally relevant cut-off age of 18 completed years. The objective of our study was to analyse the expert reports of forensic age estimation issued in Barcelona between 2011 and 2018. METHOD In all cases, data on the medical history, physical examination, radiology of the left hand and orthopantomography were collected. In cases without third molars and a complete ossification of the hand, a CT scan of the clavicles was also performed. RESULTS A total of 2754 expert reports were evaluated; 96.7% were males, the majority were of North African origin, mainly from Morocco (63.6%), and 19.6% were sub-Saharan Africans; 65.4% had a level of bone maturation corresponding to the last three standards of Greulich and Pyle. Most cases had mineralization of the third molar corresponding to the F, G or H stages of Demirjian. In 85.9%, there was a correspondence between bone and dental age. A total of 28.8% of the subjects were evaluated as being aged over 18 years; 86.2% of North Africans were considered to be younger than 18, and 82% of sub-Saharan Africans were considered to be over 18 years old. CONCLUSIONS In Barcelona, most of the subjects evaluated were male and North African, and 71.2% of the cases were considered to be minors.
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Affiliation(s)
| | - Amadeo Pujol-Robinat
- Institut de Medicina Legal i Ciències Forenses de Catalunya, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Facultat de Medicina i Ciències de La Salut, Universitat de Barcelona, Barcelona, Spain
| | | | | | | | - Jaume Pomés Tallo
- grid.410458.c0000 0000 9635 9413Servei de Radiodiagnòstic, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - Laura Oleaga Zufiría
- grid.410458.c0000 0000 9635 9413Servei de Radiodiagnòstic, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - Alexandre Xifró Collsamata
- Institut de Medicina Legal i Ciències Forenses de Catalunya, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Facultat de Medicina i Ciències de La Salut, Universitat de Barcelona, Barcelona, Spain
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6
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Lossois M, Cyteval C, Baccino E, Peyron PA. Forensic age assessments of alleged unaccompanied minors at the Medicolegal Institute of Montpellier: a 4-year retrospective study. Int J Legal Med 2022; 136:853-859. [PMID: 35278098 PMCID: PMC8917363 DOI: 10.1007/s00414-022-02813-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/05/2022] [Indexed: 12/03/2022]
Abstract
Background As many other European countries, France has to deal with a growing number of migrants including some who contend age minority entitling them to benefits and privileges reserved for children within the context of legal proceedings. In case of doubtful minority, medical examinations may be carried out to assess skeletal and dental age. Our objective was to analyse the age assessments regarding individuals of doubtful minority assertion at the Medico-legal Institute of the University Hospital of Montpellier since 2018. Methods Expert reports of forensic age assessments performed during the 2018–2021 period were reviewed. Demographic data and results from medical and radiological investigations based on AGFAD recommendations were recorded in each case. When available, conclusions of judicial investigations about the individuals’ actual age were collected. Results A total of 265 reports were compiled. Age assessments predominantly concerned males (97.7%) and the main reported country of origin was sub-Saharan Africa (80.4%). The mean reported age was 16.3 ± 0.8 years. The individual’s stated age was compatible with the age assessment in 31 cases (11.7%), while expert reports concluded that the age of majority had been reached in 131 cases (49.4%). In cases of discrepancies, the average difference between the stated and the assessed lowest possible age (= assessed minimum age) was 2.7 ± 2.3 years and 6.9 ± 3.8 years between the stated and the most probable age. Age assessments could be compared with actual ages determined by court proceedings in 27 cases, with established ages being systematically higher than the assessed minimum ages (mean difference = 4.4 ± 4.0 years). The difference between actual and stated ages ranged from 1.8 up to 18.9 years (mean difference = 6.4 ± 4.0 years). The used protocol never led to any age overestimation in this population. Conclusion Our study reinforces the relevance of AGFAD recommendations for forensic age assessment and calls for the harmonization of practices based on this methodology in the European countries.
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Affiliation(s)
- Maisy Lossois
- Department of Forensic Medicine, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Catherine Cyteval
- Department of Radiology, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Eric Baccino
- Department of Forensic Medicine, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Pierre-Antoine Peyron
- Department of Forensic Medicine, CHU Montpellier, University of Montpellier, Montpellier, France.
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7
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Cameriere R, De Luca S, Ferrante L. Study of the ethnicity's influence on the third molar maturity index (I 3M) for estimating age of majority in living juveniles and young adults. Int J Legal Med 2021; 135:1945-1952. [PMID: 34023943 DOI: 10.1007/s00414-021-02622-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 05/17/2021] [Indexed: 12/18/2022]
Abstract
Estimation of age of majority has important applications in the forensic daily practice because of the increasing demand for age estimates of unaccompanied minors. Diagnostic accuracy of I3M to assess legal adult age of 18 years has been already tested in several specific population samples. The aim of this work was to compare the available data about sensitivity and specificity of the third molar maturity index (I3M) from five different regional groups' radiographic samples to study possible ethnical difference. For this purpose, a sample of 6157 orthopantomograms (OPGs), coming from 15 countries, was analysed. Data about sensitivity and specificity were pooled using a bivariate modelling approach. The one-way MANOVA analysis was applied to assess the likelihood that sensitivity and specificity of the five regional groups are sampled from the same population. The result of the one-way MANOVA showed that both sensitivity and specificity did not depend from the regional groups. The obtained sensitivity was 84% (95% CI: 82% and 85%), and its specificity was 94% (95% CI: 93% and 95%). Based on these results, the I3M was a useful statistical tool to identify whether a subject has reached the legal age of 18 years old, regardless of his or her ethnicity.
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Affiliation(s)
- R Cameriere
- AgEstimation Project, Macerata, Italy.,Department of Forensic Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Stefano De Luca
- AgEstimation Project, Macerata, Italy. .,Área de Identificación Forense, Unidad de Derechos Humanos, Servicio Médico Legal, Santiago, Chile.
| | - L Ferrante
- Centre of Epidemiology, Biostatistics and Information Technology, Polytechnic University of Marche, Ancona, Italy
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De Tobel J, Ottow C, Widek T, Klasinc I, Mörnstad H, Thevissen PW, Verstraete KL. Dental and Skeletal Imaging in Forensic Age Estimation: Disparities in Current Approaches and the Continuing Search for Optimization. Semin Musculoskelet Radiol 2020; 24:510-522. [PMID: 33036039 DOI: 10.1055/s-0040-1701495] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Medical imaging for forensic age estimation in living adolescents and young adults continues to be controversial and a subject of discussion. Because age estimation based on medical imaging is well studied, it is the current gold standard. However, large disparities exist between the centers conducting age estimation, both between and within countries. This review provides an overview of the most common approaches applied in Europe, with case examples illustrating the differences in imaging modalities, in staging of development, and in statistical processing of the age data. Additionally, the review looks toward the future because several European research groups have intensified studies on age estimation, exploring four strategies for optimization: (1) increasing sample sizes of the reference populations, (2) combining single-site information into multifactorial information, (3) avoiding ionizing radiation, and (4) conducting a fully automated analysis.
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Affiliation(s)
- Jannick De Tobel
- Department of Diagnostic Sciences - Radiology, Ghent University, Ghent, Belgium.,Department of Imaging and Pathology - Forensic Odontology, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, Leuven University Hospitals, Leuven, Belgium.,Unit of Head and Neck and Maxillofacial Radiology, Division of Radiology, Diagnostic Department, Geneva University Hospital, Geneva, Switzerland
| | - Christian Ottow
- Department of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - Thomas Widek
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Graz, Austria.,Medical University of Graz, Graz, Austria.,BioTechMed-Graz, Graz, Austria
| | - Isabella Klasinc
- Diagnostic and Research Institute of Forensic Medicine, Medical University of Graz, Graz, Austria
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9
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Forensic age assessment of living adolescents and young adults at the Institute of Legal Medicine, Münster, from 2009 to 2018. Int J Legal Med 2020; 134:745-751. [PMID: 31907616 DOI: 10.1007/s00414-019-02239-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
Due to high migration inflows to Europe, forensic age assessment of living persons has clearly gained importance. If there is a legal justification for X-ray examinations without a medical indication, the Study Group on Forensic Age Diagnostics (AGFAD) recommends the combination of a physical examination with anamnesis, an X-ray examination of the hand and a dental examination with evaluation of an orthopantomogram for age assessments of adolescents and young adults. If the development of the hand skeleton has been completed, an additional CT examination of the clavicles is to be performed. To demonstrate the outcome of forensic age assessments according to AGFAD recommendations with regard to migrants of doubtful minority declaration, this study analyzes the expert reports carried out at the Institute of Legal Medicine, Münster, from 2009 to 2018. A total of 597 age assessments were performed during the study period. A total of 227 age assessments were issued on behalf of youth welfare offices in the legal area of social law, 282 in family law proceedings, 76 in criminal proceedings, and 12 age assessments in immigration law proceedings. In 211 out of 597 cases, the stated age was compatible with the findings of the age assessment. In the remaining 386 cases, the average difference between the stated age and the minimum age was 1.9 years. The average difference between stated age and most probable age was 5.1 years. Of the 521 age assessments carried out outside criminal proceedings, 197 unaccompanied minors with questionable age minority (37.8%) have reached the age of majority beyond doubt. A total of 388 unaccompanied minors (74.5%) have most probably reached the age of majority. Forensic age assessments with the AGFAD methodology make an important contribution to legal certainty, the welfare of the child, and the fair distribution of resources.
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10
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Rudolf E, Kramer J, Schmidt S, Vieth V, Winkler I, Schmeling A. Intraindividual incongruences of medially ossifying clavicles in borderline adults as seen from thin-slice CT studies of 2595 male persons. Int J Legal Med 2017; 132:629-636. [PMID: 28944440 DOI: 10.1007/s00414-017-1694-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 09/19/2017] [Indexed: 11/25/2022]
Abstract
In the past, numerous studies have documented the possibility of intraindividual differing appearances of the paired age-marker "medial clavicular ossification" in borderline adults. However, the extent of the divergences is rarely mentioned. Against that the article describes this phenomenon from a large sample of 2595 male persons by means of thin-slice CT imaging of the sternoclavicular regions. For determining the ossification stage of the medial clavicles, the two accepted classifications by Schmeling et al. (five main stages) and Kellinghaus et al. (six substages) were applied and buildings deviating from that labelled as atypical "norm variants". The longstanding observation could be confirmed that intraindividual stage discrepancies of this age indicator are generally moderate and do not exceed one main stage or two substages of the respective classifications. It is concluded that stage determination should be scrutinized, if a dissimilarity seems to show larger differences.
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Affiliation(s)
- Ernst Rudolf
- , Wiesenstr. 20, 4800, Attnang-Puchheim, Austria.
| | - Josef Kramer
- Institute for CT and MRT Diagnostics, Rainerstr. 6-8, 4020, Linz, Austria
| | - Sven Schmidt
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Volker Vieth
- Department of Clinical Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.,Clinic for Radiology, Klinikum Ibbenbüren, Große Straße 41, 49477, Ibbenbüren, Germany
| | | | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
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11
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Metsäniitty M, Varkkola O, Waltimo-Sirén J, Ranta H. Forensic age assessment of asylum seekers in Finland. Int J Legal Med 2016; 131:243-250. [DOI: 10.1007/s00414-016-1498-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022]
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12
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Schmeling A, Dettmeyer R, Rudolf E, Vieth V, Geserick G. Forensic Age Estimation. DEUTSCHES ARZTEBLATT INTERNATIONAL 2016; 113:44-50. [PMID: 26883413 PMCID: PMC4760148 DOI: 10.3238/arztebl.2016.0044] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/23/2015] [Accepted: 11/23/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Forensic age estimation is requested by courts and other government authorities so that immigrants whose real age is unknown should not suffer unfair disadvantages because of their supposed age, and so that all legal procedures to which an individual's age is relevant can be properly followed. 157 age estimations were requested in Berlin in 2014, more than twice as many as in 2004. METHODS This review is based on pertinent articles retrieved by a selective search in the PubMed and MEDPILOT databases, supplemented by relevant recommendations and by the findings of the authors' own research. RESULTS The essential components of age estimation are the history, physical examination, X-rays of the hands, panorama films of the jaws, and, if indicated, a thin-slice CT of the medial clavicular epiphyses, provided that there is a legal basis for X-ray examinations without a medical indication. Multiple methods are always used in combination, for optimal accuracy. Depending on the legal issues at hand, the examiner may be asked to estimate the individual's minimum age and/or his or her most probable age. The minimum-age concept can be used in determinations whether an individual has reached the age of legal majority. It is designed to ensure that practically all persons classified as adults have, in fact, attained legal majority, even though some other persons will be incorrectly classified as minors. CONCLUSION Forensic age estimation lets courts and other government authorities determine the official age of persons whose actual age is unknown-in most cases, unaccompanied refugees who may be minors. The goal is to carry out age-dependent legal procedures appropriately in accordance with the rule of law. The minimum-age concept is designed to prevent the erroneous classification of minors as legal adults.
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Affiliation(s)
| | | | | | - Volker Vieth
- Department of Clinical Radiology, University Hospital Münster; Department of Radiology, Hospital Ibbenbüren
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