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Medicine Group Research Article 記事ID: igmin246

Evaluating Digital Imaging Technologies for Anogenital Injury Documentation in Sexual Assault Cases

Forensic Medicine Obstetrics & Gynecology DOI10.61927/igmin246 Affiliation

Affiliation

    1Michigan State University, College of Human Medicine, Department of Emergency Medicine, Grand Rapids, MI, USA

    2YWCA Nurse Examiner Program, Grand Rapids, MI, USA

    3Corewell Health, Michigan State University, Emergency Medicine Residency Program, Grand Rapids, MI, USA

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要約

Purpose: Photo-documentation is a critical component of care and an indispensable skill for forensic clinicians treating patients who have experienced violence and trauma. This retrospective study examines the frequency and nature of anogenital injuries identified through colposcope digital imaging in comparison to those detected using a high-resolution camera system.
Methods: This retrospective, before-and-after study evaluated genital injuries in all adult women (over 16 years old) who presented to a freestanding Nurse Examiner Clinic (NEC) following sexual assault during a 3-year period. The clinic is supervised by forensic clinicians trained in conducting medical-forensic examinations. In 2016-2017, all injuries were documented using the Cooper Surgical Leisegang© colposcope system, while in 2018, injuries were recorded exclusively with a high-resolution camera system. The primary outcome was the frequency of genital findings documented in sexual assault victims from each group.
Results: A total of 367 women were evaluated in the "before" period and 180 in the "after" period. Both groups were similar in terms of demographics, assault history, time to examination, alcohol use, and the occurrence of genital injuries (76.1% vs. 74.9%, p = 0.76). However, patients examined with the high-resolution camera system had a significantly higher number of documented anogenital injuries (2.4 vs. 1.8, p < 0.001). This group also had more anogenital abrasions identified (51.1% vs. 27.0%, p < 0.001). The injury patterns between the two groups were not statistically different.
Conclusion: Accurate and reliable photo documentation are the key components of forensic medical documentation. Our findings indicate that the detection of anogenital injuries may differ based on the imaging system used.

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参考文献

    1. Sommers MS, Fisher BS, Karjane HM. Using colposcopy in the rape exam: health care, forensic, and criminal justice issues. J Forensic Nurs. 2005 Spring;1(1):28-34, 19. doi: 10.1111/j.1939-3938.2005.tb00008.x.
    2. Teixeira WR. Hymenal colposcopic examination in sexual offenses. Am J Forensic Med Pathol. 1981 Sep;2(3):209-15. doi: 10.1097/00000433-198109000-00004.
    3. Sommers MS. Defining patterns of genital injury from sexual assault: a review. Trauma Violence Abuse. 2007 Jul;8(3):270-80. doi: 10.1177/1524838007303194.
    4. Rogers A, McIntyre SL, Rossman L, Solis S, Bacon-Baguley TA, Jones J. The forensic rape examination: is colposcopy really necessary? Am J Emerg Med. 2019 May;37(5):999-1000. doi: 10.1016/j.ajem.2018.10.015.
    5. Astrup BS, Lauritsen J, Thomsen JL, Ravn P. Colposcopic photography of genital injury following sexual intercourse in adults. Forensic Sci Med Pathol. 2013 Mar;9(1):24-30. doi: 10.1007/s12024-012-9394-2.
    6. Jones JS, Rossman L, Wynn B, Dunnuck C, Reiter S. Accuracy and reliability of photo-colposcopy in the documentation of anogenital injuries after sexual assault. Ann Emerg Med. 2005;46.
    7. Allen W. Utilizing contrast photography and invert filters. End Violence against Women International. 2018. Available from: https://evawintl.org/wp-content/uploads/2015-03_TB-SDFI-Series-Part-1-Contrast-Filter.pdf Accessed June 30, 2023.
    8. Rossman L, Dunnuck C. A community sexual assault program based in an urban YWCA: the Grand Rapids experience. J Emerg Nurs. 1999 Oct;25(5):424-7. doi: 10.1016/s0099-1767(99)70104-2.
    9. Slaughter L, Brown CR, Crowley S, Peck R. Patterns of genital injury in female sexual assault victims. Am J Obstet Gynecol. 1997 Mar;176(3):609-16. doi: 10.1016/s0002-9378(97)70556-8.
    10. Vu A, Moaddel V, Emmerich B, Rossman L, Bach J, Seamon J, Barnes M, Ouellette L, Jones J. Association between the victim’s menstrual cycle phase and genital injuries following sexual assault. Clin J Obstet Gynecol. 2023;6:038-042. doi: 10.29328/journal.
    11. Rambow B, Adkinson C, Frost TH, Peterson GF. Female sexual assault: medical and legal implications. Ann Emerg Med. 1992 Jun;21(6):727-31. doi: 10.1016/s0196-0644(05)82788-x.
    12. Gray-Eurom K, Seaberg DC, Wears RL. The prosecution of sexual assault cases: correlation with forensic evidence. Ann Emerg Med. 2002 Jan;39(1):39-46. doi: 10.1067/mem.2002.118013.
    13. McGregor MJ, Le G, Marion SA, Wiebe E. Examination for sexual assault: is the documentation of physical injury associated with the laying of charges? A retrospective cohort study. CMAJ. 1999 Jun 1;160(11):1565-9.
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