Establishing Standards for Side-by-Side Radiographic Comparisons

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The objectives of this research were to evaluate the use of various anatomical features that are visible in standard radiographs and to develop a standard system of assessing concordant features for making positive identifications through radiographic comparison.

The radiographs used in the study include craniofacial (n = 41), chest (n = 100), and proximal femur (n = 49), which were made available by the North Carolina Office of the Chief Medical Examiner. Radiographs were scored for number of concordant features and were analyzed using classification decision trees. The accuracy of the classification tree models was evaluated using a receiver operating characteristic.

Two or more points of concordance are required in lateral cranial radiographs for a 97% probability of a positive identification. If more than 1 concordant feature exists on the cervical vertebrae, there is a 99% probability of correct identification. For thoracic and lumbar vertebrae, 4 or more concordant features are required for a 98% probability of correct identification. If there are 1 or more femoral head and neck concordant features, the probability of a correct identification is 94% and 97%, respectively. This study established the minimum number of concordant areas needed to confirm positive identifications in 3 standard radiographic views.

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