Forensics: Forensic Pathology study on skin injury patterns shows lack of agreement

Published in the Apr 15 2016 Journal of Forensic Sciences, this paper are the results of a NAME (US medical examiners) online study of human skin injury pattern diagnostic categories ( the basics of “blunt,” “sharp,” and “source” identification) undertaken by some of its members.  It’s significantly better than the bitemark group’s testing of bitemark patterns.”

Remember though, that the forensic contexts are different. Sharp vs blunt disagreement does not lead to a mis-identification of a innocent defendant.

One also might wonder what other patterns “patterns” where these folks don’t strongly agree. There are diagnostic patterns in Shaken Baby Syndrome, called the SBS “triad” that are at the center of a raging debate in and out of courtrooms and the media.

Get a.pdf of Forensic Pathologist Consensus in the Interpretation of Photographs of Patterned Injuries of the Skin here.


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.


About csidds

Dr. Michael Bowers is a long time forensic consultant in the US and international court systems.
This entry was posted in AAFS, CSI, expert testimony and tagged , , , . Bookmark the permalink.

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