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Alibrio MN, Tallman SD. The Effect of Cancer and Cancer Treatment on Pubic Symphysis Age Estimation Using Computed Tomography Scans. Diagnostics (Basel) 2024; 14:1500. [PMID: 39061639 PMCID: PMC11275384 DOI: 10.3390/diagnostics14141500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
It is currently unknown whether cancer and cancer treatment affect age-related skeletal changes used in the biological profile for skeletonized remains. This research examines the effects of cancer on skeletal age estimation using computed tomography (CT) scans of the pubic symphyses for 307 individuals from the New Mexico Descendent Image Database. The Suchey-Brooks method was applied to 125 individuals without documented cancer and 182 individuals with documented cancer. Individuals were correctly aged if their chronological age fell within the original study's 95% prediction range. Though not statistically significant, the results show that females with cancer were aged correctly 74.7% of the time, and females without cancer were aged correctly 85.1% of the time; males with cancer were aged correctly 46.0% of the time, and males without cancer were aged correctly 55.7% of the time. Additionally, a total of 30 individuals were reanalyzed to examine intraobserver error, and a Cohen's kappa value of k = 0.600 indicated a moderate level of agreement. While no statistical differences were found between cancer and control groups, CT scans may lack the resolution needed to visualize the nuanced effects of bone mineral density loss, if present, and the overall quality of bone, despite their proven utility in dry-bone skeletal analyses.
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Affiliation(s)
- Maya N. Alibrio
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA;
| | - Sean D. Tallman
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA;
- Department of Anthropology, Boston University, Boston, MA 02215, USA
- Department of Human Biology, Division of Clinical Anatomy and Biological Anthropology, University of Cape Town, Cape Town 8001, South Africa
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Warrier V, Shedge R, Garg PK, Dixit SG, Krishan K, Kanchan T. Applicability of the Suchey-Brooks method for age estimation in an Indian population: A computed tomography-based exploration using Bayesian analysis and machine learning. MEDICINE, SCIENCE, AND THE LAW 2024; 64:126-137. [PMID: 37491861 DOI: 10.1177/00258024231188799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Age estimation occupies a prominent niche in the identification process. In cases where skeletal remains present for examination, age is often estimated from markers distributed throughout the skeletal framework. Within the pelvis, the pubic symphysis constitutes one of the more commonly utilized skeletal markers for age estimation, with the Suchey-Brooks method comprising one of the more commonly employed methods for pubic symphyseal age estimation. The present study was targeted towards assessing the applicability of the Suchey-Brooks method for pubic symphyseal age estimation, an aspect largely unreported for an Indian population. In order to do so, clinically undertaken pelvic computed tomography scans of individuals were evaluated using the Suchey-Brooks method, and the error associated with the method was established using Bayesian analysis and different machine learning regression models. Amongst different supervised machine learning models, support vector regression and random forest furnished lowest error computations in both sexes. Using both Bayesian analysis and machine learning, lower error computations were observed in females, suggesting that the method demonstrates greater applicability for this sex. Inaccuracy and root mean square error obtained with Bayesian analysis and machine learning illustrates that both statistical modalities furnish comparable error computations for pubic symphyseal age estimation using the Suchey-Brooks method. However, given the numerous advantages associated with machine learning, it is recommended to use the same within medicolegal settings. Error computations obtained with the Suchey-Brooks method, regardless of the statistical modality utilized, indicate that the method should be used in amalgamation with additional markers to garner accurate estimates of age.
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Affiliation(s)
- Varsha Warrier
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Rutwik Shedge
- School of Forensic Sciences, National Forensic Sciences University, Tripura, India
| | - Pawan Kumar Garg
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Shilpi Gupta Dixit
- Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, India
| | - Kewal Krishan
- Department of Anthropology, UGC Centre of Advanced Study, Panjab University, Chandigarh, India
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
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Xiong J, Ma Y, Cao Y, Yang X, Ma J, Zhang J, Wan C, Huang P. Age estimation by modified Suchey-Brooks method using three-dimensional reconstructed CT images of Chinese Han population. Leg Med (Tokyo) 2023; 65:102304. [PMID: 37562072 DOI: 10.1016/j.legalmed.2023.102304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 07/07/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
The method proposed by Suchey-Brooks for adult age estimation based on the surface morphology of the pubic symphysis has been widely accepted. The applicability of the method varies considerably in different populations. The present study established a virtual reference sample and aimed to develop population-specific criteria that can be used for age estimation in different skeletal samples. First, The dry bone specimens from 100 individuals were compared with their corresponding three-dimensional (3D) reconstruction model and showed high inter-method agreement (k = 0.743-0.811), suggesting that the virtual bone model and physical bone specimens have comparable performances in describing the surface morphology of the pubic symphysis. We retrospectively collected clinical computed tomography (CT) data from 895 Chinese patients to create a virtual reference sample of the pubic symphysis. Based on the original Suchey-Brooks method, each of the 895 reference samples was assigned a phase, for each sex and phase, data on the mean age, standard deviation, and 95% age range of the corresponding sample were obtained, which was then used as the "method modified for Chinese" (modified method) and compared to the "SB method". Compared to the SB method, modified method had a lower inaccuracy in dry bones for males over 35 years and females over 45 years, in dry bone CT test sample for males over 55 years and females over 45 years, and in postmortem CT test sample for males over 35 years and females over 55 years. The modified method can improve the accuracy of age estimation for older samples over 40 years. It has shown considerable reliability when applied as a population-specific criterion, but its accuracy is still not sufficient, and caution is needed when using it.
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Affiliation(s)
- Jian Xiong
- Department of Forensic Medicine, Guizhou Medical University, Guizhou Guiyang 550004, PR China; Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of Justice, Shanghai 200063, PR China
| | - Yonggang Ma
- Department of Medical Imaging, 3201 Hospital Affiliated, Xi'an Jiaotong University School of Medicine, Hanzhong 723000, PR China
| | - Yongjie Cao
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of Justice, Shanghai 200063, PR China
| | - Xiaotong Yang
- School of Forensic Medicine, Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Jiwei Ma
- School of Basic Medical Science, Inner Mongolia Medical University, Hohhot, Inner Mongolia Nei Mongol 010110, PR China
| | - Ji Zhang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of Justice, Shanghai 200063, PR China.
| | - Changwu Wan
- Department of Forensic Medicine, Guizhou Medical University, Guizhou Guiyang 550004, PR China.
| | - Ping Huang
- Department of Forensic Medicine, Guizhou Medical University, Guizhou Guiyang 550004, PR China; Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of Justice, Shanghai 200063, PR China.
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Schanandore JV, Wolden M, Smart N. The accuracy and reliability of the Suchey-Brooks pubic symphysis age estimation method: Systematic review and meta-analysis. J Forensic Sci 2021; 67:56-67. [PMID: 34617597 DOI: 10.1111/1556-4029.14911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/25/2021] [Accepted: 09/14/2021] [Indexed: 11/26/2022]
Abstract
Suchey-Brooks method has been studied many times with varying reports of accuracy and reliability. A systematic review and meta-analyses were utilized to quantitatively determine the accuracy and reliability of the Suchey-Brooks (S-B) method. A systematic search of PubMed and EBSCO health and medical databases was performed. Meta-analyses were performed to quantify the relationship between actual known age at death and the S-B method using Spearman's Rho and Pearson's r for (1) combined males and females estimates, (2) male-only estimates, and (3) female-only estimates. Overall correlation coefficient using Cohen's kappa, Spearman's Rho, and Pearson's r was also calculated to determine the interrater and intrarater reliability using the S-B method. Eighteen studies classified as moderate-to-high methodological quality met the inclusion criteria. The sample sizes were different for the combined male and female (n = 2620), male-only (n = 2602), and female-only (n = 1431) meta-analyses. The effect size of the age at death meta-analyses was large and significant for combined males and females (Spearman's Rho = 0.62; Pearson's r = 0.65), male-only (Spearman's Rho = 0.77; Pearson's r = 0.75), and female-only (Spearman's Rho = 0.71; Pearson's r = 0.71). The overall correlation coefficients of the interrater (Kappa = 0.76; Spearman's Rho = 0.73; Pearson's r = 0.80) and intrarater (Kappa = 0.81; Spearman's Rho = 0.91; Pearson's r = 0.83) reliability meta-analyses were large and significant. A significant degree of heterogeneity was present in all meta-analyses, with minimal evidence of publication bias. The meta-analyses results suggest the S-B method is highly reliable with a moderate-to-high degree of accuracy. Our results also identified sample size and accuracy differences between male and female individuals.
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Affiliation(s)
| | - Mitch Wolden
- Physical Therapy Program, University of Jamestown, Fargo, North Dakota, USA.,School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, New South Wales, Australia
| | - Neil Smart
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, New South Wales, Australia
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Computed tomographic age estimation from the pubic symphysis using the Suchey-Brooks method: A Systematic Review and Meta-analysis. Forensic Sci Int 2021; 325:110811. [PMID: 34229142 DOI: 10.1016/j.forsciint.2021.110811] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 01/22/2023]
Abstract
Forensic age estimation is routinely applied in investigations involving identification of individuals. Over the past century a myriad of methods have been devised for age estimation. One such method, proposed by Suchey and Brooks in 1990, groups the observed changes occurring in the pubic symphysis into six phases, each defined by a corresponding age range. The present study was piloted with the focussed question being to empirically determine the accuracy of the Suchey-Brooks method in computed tomographic age estimation by analysing morphological changes occurring in the pubic symphysis. Original articles pertaining to the use of the Suchey-Brooks method for CT based age estimation were extracted from four different databases- PubMed, CENTRAL, Google Scholar and ScienceDirect. Research papers which were answering the focussed question were selected for data analysis. After assessing the risk of bias of the selected articles, the data was subjected to Meta-analysis. Pooled analysis of correctly/accurately aged individuals/remains using the random and fixed effect models yielded a prediction percentage of 78% and 86%, respectively. Higher percentages were obtained for phase-wise and subgroup analysis, indicating that the Suchey-Brooks method is a reliable method for age estimation.
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Joubert LC, Briers N, Meyer A. Evaluation of the Enhanced Computational Methods of Estimating Age-at-Death Using the Pubic Symphyses of a White South African Population. J Forensic Sci 2019; 65:37-45. [PMID: 31483501 DOI: 10.1111/1556-4029.14180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/31/2019] [Accepted: 08/13/2019] [Indexed: 11/28/2022]
Abstract
To address problems of reproducibility related to current age estimation methods, the enhanced computational Methods (ECM) were previously developed using a sample of white North American male pubic symphyses and showed promise in improving current techniques. However, given the evidence of sex and population differences in the onset of age markers, this study set out to test the ECM on a white South African sample. The sample consisted of 184 well-preserved os coxae from individuals of known age and sex. Pubic symphyseal surfaces were scanned using the Artec Spider 3D scanner, processed using Artec Studio 10 and analyzed using forAge. Point estimates of age were then compared to the true age of each individual. Results indicate that the ECM performed poorly in a white South African population, with consistent underestimation of age-at-death and weak positive correlations with true age. Despite the low correlations, the ECM did, however, reduce observer error.
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Affiliation(s)
- Laurette C Joubert
- School of Anatomical Sciences, University of the Witwatersrand, 7 York Road, Johannesburg, 2193, South Africa
| | - Nanette Briers
- School of Anatomical Sciences, University of the Witwatersrand, 7 York Road, Johannesburg, 2193, South Africa
| | - Anja Meyer
- School of Anatomical Sciences, University of the Witwatersrand, 7 York Road, Johannesburg, 2193, South Africa
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