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A scoring system for assessing the Manner of Death in Stab Injuries to the Trunk (The MODSIT score)

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Title: A scoring system for assessing the Manner of Death in Stab Injuries to the Trunk (The MODSIT score)
Authors: von Linde, Maria Berg, Acosta, Stefan, Khoshnood, Ardavan M., Wingren, Carl Johan
Contributors: Lund University, Faculty of Medicine, Department of Clinical Sciences, Malmö, Forensic Medicine, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Malmö, Rättsmedicin, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Malmö, Vascular Diseases - Clinical Research, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Malmö, Vaskulära sjukdomar - kliniska studier, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section II, Medicine/Emergency Medicine, Lund, Emergency medicine, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion II, Medicin/akutsjukvård, Lund, Akutsjukvård, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Malmö, Cardiovascular Research - Hypertension, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Malmö, Kardiovaskulär forskning - hypertoni, Originator, Lund University, Profile areas and other strong research environments, Strategic research areas (SRA), EpiHealth: Epidemiology for Health, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Strategiska forskningsområden (SFO), EpiHealth: Epidemiology for Health, Originator
Source: Forensic Science International. 377:1-6
Subject Terms: Medical and Health Sciences, Other Medical and Health Sciences, Forensic Science, Medicin och hälsovetenskap, Annan medicin och hälsovetenskap, Rättsmedicin
Description: Introduction Distinguishing between homicide and suicide in cases of single stab injuries to the trunk can be challenging, particularly in the absence of clear contextual information. This study aims to address this issue by developing the MODSIT score (Manner of Death in Stab Injuries to the Trunk)—an evidence-based scoring system designed to standardise forensic manner of death assessments. Method We developed four score models based on: 1) autopsy findings alone; 2) autopsy findings and toxicology; 3) autopsy findings, toxicology, and circumstances at the death scene; and 4) autopsy findings, toxicology, death scene circumstances, and demographics. The diagnostic performance of the models was evaluated through Receiver Operating Characteristic (ROC) curve analysis. Results Model 3, including autopsy findings, toxicology, and circumstances at the death scene, established the best diagnostic performance (AUC 0.99, 95% CI 0.97–1.00). The optimal cut-off of 2 score points showed 91.8% sensitivity and 97.6% specificity for predicting homicide, and cut-off of –1 point showed 85.7% sensitivity and 98.8% specificity for predicting suicide. Discussion and conclusion The score needs to be validated in other populations to confirm its generalisability. The MODSIT score has the potential to become a valuable tool for evidence-based forensic practice.
Access URL: https://doi.org/10.1016/j.forsciint.2025.112666
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  Data: <searchLink fieldCode="AR" term="%22von+Linde%2C+Maria+Berg%22">von Linde, Maria Berg</searchLink><br /><searchLink fieldCode="AR" term="%22Acosta%2C+Stefan%22">Acosta, Stefan</searchLink><br /><searchLink fieldCode="AR" term="%22Khoshnood%2C+Ardavan+M%2E%22">Khoshnood, Ardavan M.</searchLink><br /><searchLink fieldCode="AR" term="%22Wingren%2C+Carl+Johan%22">Wingren, Carl Johan</searchLink>
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  Data: Lund University, Faculty of Medicine, Department of Clinical Sciences, Malmö, Forensic Medicine, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Malmö, Rättsmedicin, Originator<br />Lund University, Faculty of Medicine, Department of Clinical Sciences, Malmö, Vascular Diseases - Clinical Research, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Malmö, Vaskulära sjukdomar - kliniska studier, Originator<br />Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section II, Medicine/Emergency Medicine, Lund, Emergency medicine, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion II, Medicin/akutsjukvård, Lund, Akutsjukvård, Originator<br />Lund University, Faculty of Medicine, Department of Clinical Sciences, Malmö, Cardiovascular Research - Hypertension, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Malmö, Kardiovaskulär forskning - hypertoni, Originator<br />Lund University, Profile areas and other strong research environments, Strategic research areas (SRA), EpiHealth: Epidemiology for Health, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Strategiska forskningsområden (SFO), EpiHealth: Epidemiology for Health, Originator
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  Data: <i>Forensic Science International</i>. 377:1-6
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  Data: Introduction Distinguishing between homicide and suicide in cases of single stab injuries to the trunk can be challenging, particularly in the absence of clear contextual information. This study aims to address this issue by developing the MODSIT score (Manner of Death in Stab Injuries to the Trunk)—an evidence-based scoring system designed to standardise forensic manner of death assessments. Method We developed four score models based on: 1) autopsy findings alone; 2) autopsy findings and toxicology; 3) autopsy findings, toxicology, and circumstances at the death scene; and 4) autopsy findings, toxicology, death scene circumstances, and demographics. The diagnostic performance of the models was evaluated through Receiver Operating Characteristic (ROC) curve analysis. Results Model 3, including autopsy findings, toxicology, and circumstances at the death scene, established the best diagnostic performance (AUC 0.99, 95% CI 0.97–1.00). The optimal cut-off of 2 score points showed 91.8% sensitivity and 97.6% specificity for predicting homicide, and cut-off of –1 point showed 85.7% sensitivity and 98.8% specificity for predicting suicide. Discussion and conclusion The score needs to be validated in other populations to confirm its generalisability. The MODSIT score has the potential to become a valuable tool for evidence-based forensic practice.
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