Improving the Forensic Documentation of Injuries Through Alternate Light: A Researcher–Practitioner Partnership

Scafide, Katherine N.; Ekroos, Rachell A.; Mallinson, R. Kevin; Alshahrani, Abeer; Volz, Jessica; Holbrook, Debra S.; Hayat, Matthew J.

doi:10.1097/jfn.0000000000000389

Cited by 4 publications

(4 citation statements)

References 29 publications

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“…developed [29]. Clinicians should follow these guidelines to ensure they are utilizing ALS appropriately to avoid false positive findings.…”

Section: Discussionmentioning

confidence: 99%

“…However, to the best of our knowledge, there are no currently available studies validating single light source ALS units for this purpose. Clinical guidelines for use of ALS in medical forensic examinations have been recently developed [29]. Clinicians should follow these guidelines to ensure they are utilizing ALS appropriately to avoid false positive findings.…”

Section: Discussionmentioning

confidence: 99%

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Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial

Downing,

Scafide,

Ali

et al. 2024

Journal of Forensic Sciences

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Difficulty visualizing bruises resulting from interpersonal violence, especially in individuals with dark skin, contributes to disparities in access to justice. The purpose of this analysis was to compare bruise visibility of detected injuries using white light versus alternate light sources (ALS). Visibility was assessed using the 5‐point Bruise Visibility Scale (BVS) for white light and the ALS Visibility Scale (AVS) for ALS. Bruises were induced using controlled application of a paintball to the upper arm on 157 healthy adults across six skin color categories. Using a crossover design, the light source used first to assess the bruise (white light or ALS) was randomized. Each bruise was examined up to 21 times over 4 weeks using white light and 10 combinations of wavelengths (350 nanometer [nm] – 535 nm) and colored filters (yellow, orange, and red). Multilevel modeling was used to analyze the repeated measures data with a total 20,103 bruise assessments. Results revealed 415 nm with yellow filter resulted in an almost 0.5‐point increase in BVS/AVS score across all skin colors (Estimate = 0.46; 95% CI: 0.43, 0.49; p < 0.001), a clinically significant improvement in ability to visualize bruises. Conversely, 515 nm (Estimate = −0.80; 95% CI: −0.84, −0.76; p < 0.001) and 535 nm (Estimate = −0.64, 95% CI: −0.67, −0.60; p < 0.001) with red filter resulted in more than 0.5‐point decrease in BVS/AVS score. The use of ALS is supported by the data and results in improved bruise visibility during medical forensic examinations.

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“…developed [29]. Clinicians should follow these guidelines to ensure they are utilizing ALS appropriately to avoid false positive findings.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial

Downing,

Scafide,

Ali

et al. 2024

Journal of Forensic Sciences

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“…Scafide is currently using her expertise to develop clinical practice guidelines for forensic nurses on the use of alternate light sources to detect bruising. 2 She has also created and tested a scale to enable nurses to rate the visibility of bruises. 3 In the future, she hopes to explore the improvement of available alternative light tools to make them lighter and more easily portable.…”

Section: Innovative Solutionsmentioning

confidence: 99%

“…Future goals . Scafide is currently using her expertise to develop clinical practice guidelines for forensic nurses on the use of alternate light sources to detect bruising 2. She has also created and tested a scale to enable nurses to rate the visibility of bruises 3.…”

Section: Innovative Solutionsmentioning

confidence: 99%

Improving Bruise Detection in Patients with Dark Skin Tone

Benjamin

Giuliano

2023

AJN, American Journal of Nursing

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This is the fifth article in a series on nurse innovators, which focuses whenever possible on nurse–engineer partnerships and outlines working, replicable models of collaboration between the two disciplines. In this installment, we profile Katherine N. Scafide, a forensic nurse and researcher, who has partnered with engineers over many years to improve bruise detection in patients with dark skin tone.

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Examining the use of alternative light sources in medico-legal assessments of blunt-force trauma: a systematic review

Tyr,

Heldring,

Zilg

2024

Int J Legal Med

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The ability to analyze blunt-force trauma is crucial for deciphering valuable clues concerning mechanisms of injury and as evidence for medico-legal investigations. The use of alternate light sources (ALS) has been studied over the past decade, and is proposed to outperform conventional white light (CWL) during bruise assessments. In response to the growing interest of the technology worldwide, a systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) to address the ability of ALS to detect and visualize bruising. From an initial 4055 records identified, ten studies met the eligibly criteria and were selected for this review. Evaluation also included a novel framework, referred to as SPICOT, to further systematically assess both scientific evidence and risk of bias in forensic literature. Analysis reveals that narrowband wavelengths within in the infrared or ultraviolet spectral ranges do not significantly outperform CWL in visualizing or detecting bruising. However, wavelengths within the visible spectrum, particularly 415 nm combined with longpass or bandpass yellow filters, are more effective. However, the majority of selected studies only address the sensitivity of ALS, and therefore, results may only be considered valid when the location of a bruise is known. Further investigation is required to understand the specificity of ALS, in particular how the use of topical cosmetic products, previous wounds/scar-tissue, tattoos, moles and freckles may affect detection. The ethical concern regarding the interpretation of enhanced visualized trauma should also be considered in prospect discussions prior to implementing ALS into routine practice. Nevertheless, this review finds that narrowband ALS within the visible spectrum demonstrates potential for improved injury documentation, outperforming CWL in the detection and visualization of bruising.

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Improving the Forensic Documentation of Injuries Through Alternate Light: A Researcher–Practitioner Partnership

Cited by 4 publications

References 29 publications

Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial

Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial

Improving Bruise Detection in Patients with Dark Skin Tone

Examining the use of alternative light sources in medico-legal assessments of blunt-force trauma: a systematic review

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